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Boards important!!!!
| Question | Answer |
|---|---|
| Cd14 | Tlr on macrophages, turns on nfkb |
| Neutrophils activated by | C5a, il8, LtB4, bacterial products |
| Demargination of neutrophils | Leukocyte adhesion deficiency (lfa1) , corticosteroids |
| Cd18 | Leukocyte adhesion deficiency, it's the LFA-1 integrin. Delayed separation of umbilical cord, increased neutrophils, infx without pus |
| TGF-B | Implicated in keloids, excessive amounts!! Causes angiogenesis and fibrosis |
| Cd8 cells release | Perforins and granzyme |
| Epitheliod histocyte | Defining feature of granuloma, macrophage w pink cytoplasm |
| Pure red cell aplasia | Thymoma, anemia with low reticulocytes |
| AIRE mutation | Autoimmune polyendocrine syndrome. AIRE normally brings in self antigen into the thymus during T cell negative selection (in thymus medulla, positive selection is in cortex.) triad: hypoparathyroidism, adrenal failure, candida infx |
| Cd 95 | Fas |
| Autoimmune lymphoproliferative syndrome | Defect in fas apoptosis pathway (fas-fasl interaction defect!). Get cytopenias but proliferation of lymphocytes (lymphadenopathy, splenometaly, lymphoma). |
| Cd25 | Il2 receptor, on treg. Polymorphism associated with autoimmunity (MS, type 1 DM) |
| IPEX | FOXP3 mutation, immune dysfunction, polyendocrinopathy( thyroiditis, type 1 dm), enteropathy (diarrhea), x linked |
| Ptpn22 | Polymorphism increases risk of autoimmunity |
| Decreased ch50 | Test looks at complement, decrease means complement is being used. Seen in SLE |
| Anti smith antibodies | Anti snRNP , specific |
| Early complement deficiency | Associated with lupus |
| Discoid rash, oral nasopharyngeal ulcer, serositis | Lupus |
| Lupus antibody specific w poor prognosis | Anti-dsDNA, associated w renal disease(common cause of death) |
| Anticardiolipin | False vrdl rpr positives. Antiphospholipid syndrome |
| Sjogren associated with | Rheumatoid arthritis |
| Antiribonucleoprotein antibodies | Anti ssa and ssb, sjogren, associated with extraglandular manifestations. Ssa can cross placenta and affect fetus, cause neonatal lupus and cause congenital heart block. Some sle patients can also have ssa ssb. |
| Scleroderma | Deposition of collagen (by fibroblasts). Increased endothelin (vasoconstrictor), pdgf, tgfb, endothelial adhesion factors |
| Anti dnatopoisomerase antibody | Anti scl-70, diffuse scleroderma |
| Cause of death diffuse scleroderma | Pulmonary involvement |
| Mixed connective tissue disease | Features of sle, systemic sclerosis, and or polymyositis. Usually lack severe renal involvement, have severe pulmonary htn (cause of death). Have antibodies against u1 RNP. |
| Anti-u1 RNP | Mixed connective tissue disease |
| Cd34 | Hematopoietic stem cell marker |
| Collagenase | Replaces type III Collagen with type I, zinc is cofactor |
| Fibroblast growth factor | Angiogenisis |
| Myofibroblasts | Wound contraction |
| Inactive form of vitamin d | 24,25 oh2 d3 |
| Glut 4 | Insulin dependent: adipose tissue, striated muscle |
| Glut 5 | Fuctose |
| Glut 2 | Bidirectional, b islets, liver, kidney, small intestine |
| Glut 1 | Brain rbc cornea placenta |
| Glut 3 | Brain placenta |
| Number one cause of b12 deficiency | Chronic autoimmune gastritis(body and fundus, where most parietal cells are |
| Treacher Collins syndrome | Abnormal development of first and second pharyngeal arches. Mandibular maxillary and zygomatic bone hypoplasia, absent or abnormal ossicles ( incus and malleus first, stapes second arch) cause hearing loss. |
| Increased acetylcholinesterase | Neural tube defect |
| Duodenal atresia | Failure of recanalizarion of duodenal linen due to failure of epithelial cell apoptosis |
| What does calcium bind in muscle contraction | Troponin c |
| Uterine relaxant | B2 agonist- tocolytic! Terbutaline, ritodrine |
| Pnmt upregulated by | Cortisol |
| Drug that prolongs qt but doesn't increase risk of torsades | Amiodarone |
| Wrinkles | Decreased collagen fibril production, upregulation of metalloproteases (including collagenases) that degrade type I and III Collagen and elastin. Increased cross linking of collagen |
| Calcineurin | Il2 gene transcription via IL2. Inhibited by cyclosporine and tacrolimus |
| Neurofibromin | Tumor suppressor encoded by nf1 gene |
| Retinopathy of prematurity , or retrolental fibroplasia | Hyperoxia to treat neonatal respiratory distress causes VEGF upregulation upon return to room air, causes retinal vessel proliferation and possible retinal detachment with blindness. Mediated by free radicals |
| Why nephrotic syndrome cause hypercoagulability | ATIII Loss in urine |
| Beta lactamase inhibitors | Clavulanic acid, sulbactam, tazobactam |
| Vitamin e deficienxy | Hemolytic anemia, neuromuscular disease( dorsal column, spinocerebellar aka ataxia) |
| HIV associated dementia | Inflammatory activation of microglial cells , see microglial nodules around small areas of necrosis |
| Subarachnoid hemorrhage | Blood between arachnoid and pia matter, berry aneurism (Ehler danlos, ADPKD) |
| Charcot Bouchard aneurism | Intracerebral hemorrhage, not subarachnoid. Bc HTN. In basal ganglia, internal capsule, deep white matter. |
| Non polar amino acids | Alanine valine leucine isoleucine phenylalanine tryptophan methionine proline glycine |
| Atypical depression | Mood reactivity, leaden paralysis, increased sleep and appetite, rejection sensitivity |
| Meigs syndrome | Triad of ovarian fibrous, ascites, hydrothorax |
| Yolk Sac tumor marker | AFP |
| Dysgerminoma /Seminole tumor marker | Hcg ldh |
| Ovarian tumor and hyperthyroidism | Mature cystic teratoma |
| Ca-125 | Epithelial carcinomas of ovary |
| Beta blockers in diabetics | Can reduce awareness of hypoglycemia by reducing sympathetic symptoms (palpitations anxiety arousal) |
| Hyperparathyroidism Urine calcium | Hypercalciuria usually despite increased transcription just bc so much calcium |
| Trabecular thinning and fewer interconnections | Osteoporosis |
| Disorganized lamellar bone structure in mosaic pattern | Paget's disease |
| Osteitis fibrosis cystica | Cystic bone spaces filled with brown fibrous tissue (brown tumor of osteoclasts and deposited hemosiderin from hemorrhages, causes bone pain) due to increase PTH in hyperparathyroidism |
| Secondary hyperparathyroidism | Chronic kidney disease! Hypocalcemia, hyperphosphatemia |
| Laron syndrome | Dwarfism!! Defective GH receptors, increased GH, decreased igf-1. Short height, small head, saddle nose prominent forehead small genitalia |
| IGF-1 | Somatomedin C, how growth hormone mediates linear growth and muscle mass. Secreted by liver |
| Growth hormone inhibited by | Glucose and somatostatin |
| Trabecular thinning with fewer interconnections | Osteoporosis |
| Osteoid matrix accumulation around trabeculae | Vitamin d deficiency |
| Persistence of primary spongiosa in medullary cavity with no mature trabeculae | Osteopetrosis. Defective OSTEOCLASTS |
| Skin retraction on breast means involvement of | Suspensory ligament like cooper ligament |
| Lumbar spinal stenosis | Thickened ligamentum flavum |
| Daptomycin | Increased creatine phosphate. It depolarizers bacterial cell membrane and inhibits synthesis of DNA rna and proteins |
| Gastrojejunostomy | deficiency of iron b12, fat soluble vitamins ,and calcium |
| Decrease aqueous humor production | B blockers, a2 agonist, carbonic Anhydrase inhibitors |
| Trabecular outflow | M3 agonjst |
| Most deoxygenated blood in body | Coronary venous blood |
| Base excision repair | Glycosylase endonuclease lyase polymerase ligase |
| Libman sacks endocarditis | Vegetations on both surfaces composed of sterile platelet thrombi a fibrin immune complexes and mononuclear cells |
| Treatment for CAH aims to | Suppress acth. Give cortisol! |
| Where does h pylori colonize | Antrum aka pre pyloric area |
| Varencicline | Reduces nicotine withdrawal and reward as partial agonist |
| Hemagglutinin | Promotes viral entry. Influenza. Antibodies against HG are most important source of protection |
| Neuraminidase | Progeny Virion release in influenza |
| Primary adrenal insufficiency | Hyponatremia hyperkalemka acidosis hypotension |
| Cavernous hemangioma | Intracerebral hemorrhage bc within brain parenchyma |
| C3 nephritic factor | Ig antibody that stabilizes C3 convertase-> persistent complement activation-> decreased C3 levels. Seen in type 2 MPGN |
| Acute PSGN | In children resolves, in adults can progress to RPGN. See lumpy bumpy granular appearance bc igg, igm c3 deposition |
| Zenker diverticulum bc | Cricopharyngeal motor dysfunction |
| Decrease conversion t4 to t3 | Beta blockers, corticosteroids, propylthiouracil |
| Fibrinoid necrosis | Serum sickness, malignant htn, polyarteritis nodosa |
| A-a gradient | 5-15 mm hg |
| Hormone sensitive lipase | Catabolizes mobilization of stored TG into FFA and glycerol. Activated by catecholamines, acth, glucagon via Gs.Inhibited by insulin |
| Vitiligo | Complete or partial loss of epidermal melanocytes |
| What makes fibrous cap over atherosclerotic plaqur | Vascular Smooth muscle cells- make collagen elastin proteoglycans |
| Complication of acute pancreatitis | Paeudocyst( lined by granulation tissue not epithelium), necrosis, hemorrhage, infx, organ failure, hypocalcemja |
| Splenic red pulp | Destroys aged and abnormal erythrocytes, and clears circulating bacteria that become lodged in cords. Macrophages then present antigens to b and T cells in white pulp. Nealy half bodies immunoglobulins are produced in spleen, and makes an ospsonizinf ab |
| DHFR inhibitors | Tmp, methotrexate, pyrimethamine |
| Paroxysmal nocturnal hemoglobinuria manifestations | Hemolytic anemia, low haptoglobin, hemoglobinuria, thrombosis (release of prothrombitjc factors from RBC and platelets, pancytopenia (stem cell injury), iron dep in kidney (hemosiderosis). |
| Small intestine bacterial overgrowth | Can happen due to gastric bypass, overproduction of vitamin k and folate |
| Kawasaki complicatkon | Coronary artery aneurysm |
| Innumerable renal microaneurysms | Polyarteritis nodosa |
| Catalase positive bacteria for nadph oxidase deficiency | S aureus, burkholderia cepacia, serrata marcescsns, nocardia, aspergillus |
| Werdnig Hoffmann syndrome | Anterior horn congenital degeneration. Floppy baby. Autosomal recessive. Symmetric weakness |
| ALS can be caused by defect in | Zinc copper Superoxide dismutase 1 |
| Area postrema | Specialized brain region w no blood brain barrier, allows molecules in blood to affect brain -Vomiting post chemo. Neurohypophysis which releases adh too |
| Cortical laminar necrosis | Line of damage in pyramidal cells in layers 356 due to ischemia |
| Thrombotic vs emboli stroke | Thrombotic pale, embolic hemorrhagic |
| Berry aneurysm | Lacks media layer, susceptible to rupture. Associated w Marfan and ADPKD. Usually at anterior circle of Willis at ranch point of anterior communicating |
| Metochromatic leukodystrophy | Can't degrade myelin, accumulates |
| Adrenoleukodystropy | Impaired metabolism of very long chain fatty acids- buildup in nervous system adrenal gland and testes. |
| Normal pressure hydrocephalus | Idiopathic, elderly. Csf pressure elevated episodically- urinary incontience, ataxia cognitive dysfunction. Magnetic gait (feet appear stuck to floor) |
| Apoe4 | Increased risk of sporadic Alzheimer's disease |
| Ubiquinated TDP43 or hyperphosphorylated tau | Frontotemporal dementia (pick disease) |
| Lesion of dominant parietal cortec | Agraphia, acalculia, finger agnosia, left right disorientation. Aka Gerstmann syndrome |
| Lateral medullary Wallenberg syndrome | Pica lesion : Lateral medulla: nucleus ambiguis, dysphasia hoarseness decreased gag reflex. Vestibular nuclei spinothalamic tract Horner syndrome ataxia |
| Lateral pontine syndrome | Aica lesion: paralysis of face , Vestibular nuclei spinothalamic tract Horner syndrome ataxia |
| Medial medullary syndrome | Infarct of paramedical branches of asa and or vertebral arteries. Corticospinaltract, medial leminiscus, caudal medulla (hypoglossal nerve). |
| First line treatment intention tremor | Propanolol |
| Painful thyroid , hyper early hypo later | Subacute granulomatous thyroiditis (quervain) |
| Reidel thyroiditis | Rock hard painless goiter. Thyroid replaced by fibrous tissue with inflammatory infiltrate. An IgG4 related disease( includes autoimmune pancreatitis, retroperitoneal fibrosis, noninfectious aortitis) |
| Microscopic polyangitis involves | Lungs kidneys skin. No granuloma. |
| Wegner vasculjtis involves | nasal septum, otitis media, mastouditis, lungs, kidneys. Granulomas. |
| Churg Strauss involves | Asthma sinusitis skin peripheral neuropathy. Also can involve heart gi kidneys |
| Henoch schonlein purpura | Skin arthralgia abdominal pain. After URI. |
| Multiple sclerosis pathogenisis | Cd4 t lymphocytes activated by myelin basic protein |
| Pseudohypoparathyroidism type 1A (Albright hereditary osteodystropjy) | Unresponsiveness of kidney to PTH. Hypocalcemia despite increased PTH. Short 4/5 digest , short stature; AD. Defective Gs protein alpha subunit. Must be inherited from mom bc imprinting |
| PseudopseudohypoPTH | Physical exam of Albright hereditary osteodystropy but without end organ PTH resistance- PTH normal. Occurs when defective protein is inherited from father |
| Angiodysplasia | Tortuous dilation of vessels-> hematochezia. Most often right side of colon |
| Scarlet fever toxin | Erythrogenic toxin |
| 5-hydroxyindoleacetic acid | Breakdown product of serotonin, used to screen for carcinoid syndrome |
| Mast cell degranulation release | Histamine and tryptase. Tryptase is relatively specific to mast cells, elevated levels support diagnosis of anaphylaxis . Mast cell granules also have heparin! |
| PDGF | secreted by activated platelets and macrophages. Induces vascular remodeling and smooth muscle cell migration. Stimulates fibroblast growth for collagen synthesis. |
| Initial signs of botulinum intox | Diploplia dysphagia dysphonia. Inhibited muscarinic AND nicotinic acth release. See decreased CMAP, but rapid firing improves it (like lambert eaton) |
| Tetrodotoxin poisoning | Contaminated puffer fish. Inhibit Na influx into nerves. Weakness, parestheskas, loss of reflex. Conscious but paralyzed. Sometimes severe hypotension |
| Common cardinal veins become | Superior vena cava |
| Neuroleptic malignant syndrome | Lead pipe rigidity post antipsychotic |
| Malignant hyperthermia | Post inhaled anesthetics or succinylcholine. Fever, sever muscle contractions. Susceptibility is AD with variable penetrative bc mutation in ryanodine receptor that increases Ca release |
| VWF and VII produced in | Endothelial cells |
| Modified smooth muscle cells in afferent arteriole | Juxtaglomerular apparatus- contain zymogen granules. Renal artery stenosis causes hyperplasia of JGA. |
| Abetalipoproteinemia histo | Enterocytes with clear or foamy cytoplasm more prominent at tips of villi, impaired formation of apoB lipoproteins |
| Distended macrophages in Lamina propria of small intestine, pas positive and diastase resistant granules and rod shaped bacilli | Whipple disease |
| Abetalipoproteinemia symptoms | Malabsorption, failure to thrive, retinitis pigmentosa, vit e deficiency (spinocerebelar degen), ataxia , acanthocytosis (spur cells) |
| Myofibroblasts | Wound contraction |
| Ortner syndrome | Mitral stenosis-> left atrial enlargement -> impingement of left recurrent laryngeal nerve-> hoarseness |
| Thyroidization of kidney | Chronic pyelonephritis. Eosinophilic casts in tubules resembling thyroid tissue. |
| Dialated calyces with overlying cortical atrophy, mostly in upper and lower poles | Recurrent pyelonephritis, bc cesicputetal reflux. Scarring is usually in upper and lower poles of kidney where compound papillae are found ( they are always open unlike simple papillae in mid kidney) |
| McCune Albright | GNAS mutation in a subunit of G- persistent activity. In melanocytes- cafe auclait (usually unilateral). Precocious puberty. Increase proliferation of fibroblast like cells, il-6, and activation of osteoclasts (polyostotic fibrous dysplasia) |
| Onion skin periosteal reaction in bone | Ewing sarcoma , 11:22 translocation |
| Codman triangle or sunburst pattern on xray | Osteosarcoma. Paget disease familial retinoblastoma, li fraumeni |
| Waxing and waning lymphadenopathy | Follicular lymphoma |
| Reye syndrome | Increased ALT, AST, ammonia bilirubin prolonged PT PTT, microvesicular STEATOSIS, the presence of small fat vacuoles in cytoplasm of hepatocytes. NO NECROSIS OR INFLAMMATION PRESENT. |
| Bile duct destruction , periductal granulomatous inflammation and bile duct proliferation | Primary biliary cirrhosis |
| Onion skin bile duct fibrosis | Primary sclerosing cholangitis. See alternating structures and dilation with beading of intra and extra hepatic bile ducts |
| VIPoma | Watery diarrhea, hypokalemia, achlorhydria |
| Endothelial nitric oxide synthase | Synthesizes nitric oxide from arginine, nadph, and o2. |
| Arteriolar vasodilation in active skeletal muscles mediated by local release of | Adenosine, potassium ions, ATP, CO2, and lactate |
| Comprehension test | Multi step command |
| Hepatitis antigen indicating high transmissibility and poor prognosis | HBeAg |
| Dihydropteridine reductase | BH2->BH4 |
| Complications of prematurity | RDS, PDA, broncopulmlonary dysplasia, intraventricular hemorrhage (originates from germinal matrix), necrotizing enterocolitis, retinopathy of prematurity |
| Antibiotic with disulfiram like rxn after alcohol | Metronidazole |
| Chromatolysis | Seen in Wallerian degeneration- reaction of neuronal cell body to axonal injury. Characterized by round cellular swelling, displacement of nucleus to periphery, dispersion of isle substance throughout cytoplasm |
| Bortezamib | Proteasome inhibitor- results in accumulation of toxic intracellular proteins. Proteosomes also regulate balance of pro and anti apoptotic proteins- inhibition-> excess proapoptotic-> both = apoptosis. Plasma cells espec suscept bc ^ protein production |
| Glucagonoma | Dermatitis (necrolytic migratory erythema), diabetes (hyperglycemia), DVT, declining weight, depression, anemia. |
| Acute phase reactants | Fibrinogen ferritin c reactive protein serum amyloid a, serum amyloid p, complement factors |
| Plummer Vinson increased risk of what cancer | Squamous cell carcinoma of esophagus |
| ARPKD | Collecting ducts, associated with congenital hepatic fibrosis- portal hypertension!! |
| ADPKD | Associated with cysts in liver (benign), cysts in brain (berry aneurysm), and Mitral valve prolapse, diverticulosis |
| Medullary cystic disease | SHRUNKEN kidneys (unlike PKD) and medullary cysts |
| Ethylene glycol ingestion | Anion gap acidosis, calcium oxalate crystals, acute tubular necrosis. Treat with fomepizole (inhibits alcohol dehydrogenase) |
| Acute interstitial nephritis | EOSINOPHILS IN URINE, post drug. Fever rash hematuria, costovertrbral angle tenderness |
| Minimal change disease associated with | Hodgkin's lymphoma- Cytokine mediated damage |
| FSGN | associated with HIV, heroin use, sickle cell. |
| Nephrotic syndrome see | Hypoalbuminuria, edema, hyperlipidemia, hypercoagulabilty (ATIII loss in urine), fatty casts, hypoaglobulinemia( increased risk of infx) |
| MPGN | Type I- subepithelial, hep b and hep c Type II- dense deposits within basement membrane, c3 nephritic factor |
| Diabetic GN | Nonenzymatic glycosylation of vascular basement membrane specifically in EFFERENT arteroles |
| Nephritic syndrome associated with | Azotemia, oliguria, hypertension (due to salt retention), proteinuria, RBC cast. |
| PSGN associated with | M protein virulence factor. Subepithelial hump |
| RPGN crescent made of | Fibrin macrophages plasma proteins (c3b) |
| Stag horn caliculi | Ammonium magnesium phosphate stone or less frequently cystine stones |
| Epo produced by | Renal peritivular interetitial cells |
| JGA secrete renin in response to | Decreased renal BP and increased sympathetic tone (via B1 receptors). B blockers decrease BP by inhibiting these receptors! |
| Polycystic ovarian syndrome | Androgen excess, ovarian dysfunction, insulin resistance, obesity . Increased risk for endometrial hyperplasia |
| Acute rejection. | Vasculitis of graft vessels with dense interstitial lymphocytic infiltrate |
| Chronic transplant rejection | Interstitial fibrosis. Bronchiolitis obliterans in lung, accelerated atherosclerosis in heart, chronic graft nephropathy in kidney, vanishing bile duct syndrome in liver |
| Calcified brain tumors | Craniopharyngeoma, oligodendroglioma, meningioma (psammoma bodies) |
| Cough reflex | Sensory : vagus (internal branch of superior laryngeal), can be damaged in piriform recess. Motor: vagus |
| Membranous GN associated with | Antibodies to phospholipase a2 receptor (primary) or secondary: drugs, infx, SLE, solid tumors |
| Secretin effect on gastronoma | Stimulates gastric release paradoxally due to abnormal adenylate Cycllase activation. Use it to differentiate from other causes of hypergastrinemia |
| Fanconi anemia | DNA repair defect- bone marrow failure, macrocytosis, short stature, tumors/leukemia, cafe au lait spots, thumb/radial defects |
| Ducts distended by pleomorphic cells with prominent central necrosis without extension beyond ductal basement membrane | Comedocarcinoma subtype of Ductal carcinoma in situ |
| breast masses with orderly row of cells in single file | Lobular carcinoma |
| Breast stroma tumor w disorderly diffusely hypercellular connective tissue w cellular Atypia and leaf like projections | Phyllodes tumor, benign but may become malignant |
| Meniere disease | Increased volume and pressure of endolymph- tinnitus and feeling of fullness, vertigo, sensoromdjromal hearing loss. Recurrent episodes |
| Vestibular neuritis (labryinthitis) | Single vertigo episode, last days. No hearing loss, post viral syndrome |
| Intercellular receptors have | Zinc finger- DNA binding domain! |
| Mycobacterium avium | Fever weight loss diarrhea in HIV patient. Marked anemia, hepatosplen, and elevated alk phos and lactate dehydrogenase levels are more common a MAC than Tb bc widespread involvement of reticuloendothelial sys. Grow well at high temp. Prophy: azithromycin |
| Calcitriol | Active form of vitamin d |
| Arteriovenous nicking | Fundoscopic finding in chronic hypertension |
| Lymphocytic infiltrate of thyroid with well developed germinal centers | Hashimoto thyroiditis- also see hurthle cells |
| Inflammatory infiltrate in thyroid with macrophages and giant cells | Subacute granulomatous thyroiditis |
| Muscle weakness and loss of deep tendon reflexes , loss of vibratory sense and proprioceptipn | Friedreich ataxia, vitamin e deficiency, vitamin b12 |
| Mets to bone | Prostate breast kidney thyroid lung ( PB KTL) lead kettle |
| Heme oxygenase | Heme to biliverden(green) |
| Hemochromatosis | Mutated HFE protein leads to decreased iron uptake- heparocytes and enterocytes to sense false low iron. Enterocytes increase DMT1 expression, increasing FE abs, hepatocytes decrease hepcidase synth |
| Microsomal monooxygenase | Cytochrome p450 oxygenase!! |
| Pleural thickening and biopsy showing numerous long slender microvilli and abundant tonofilaments. Hemorrhagic pleural effusion. Psammoma bodies | Mesothelioma |
| Epoxide reductase | In liver, activates vitamin k which then is cofactor for gamma carboxylation of glutamic acid residues on clotting factors 2,7,9,10 C S |
| Caisson disease | Chronic gas emboli- multi focal ischemic necrosis of bone |
| Diamond blackfan anemia | Rapid onset anemia first year kid bc intrinsic defect in erythroid progenitor cells. Increase Hbf, decrease total Hb. Short stature, craniofacial abnormalities upper extremity malformations (triphalangeal thumbs) |
| Paroxysmal nocturnal hemlglobinuria inheritance? | ACQUIRED mutation in myeloid stem cell- increased risk of AML |
| Cyanide poisoning treatment | Nitrate + thiosulfate, hydroxcobalamin |
| Hep b cancer properties | 1. Integration into cell genome is trigger for neoplastic changes. 2. Activated synth of ILGF II Ad receptors for ILGF I stimulating cell prolif. 3. Suppression of p53 tumor suppressor/cell cycle regulatory gene in host cells |
| Haphazardly arranged myocytes and myocyte bundles, myocyte hypertrophy, fibrosis | HCM |
| Posterior 1/3 of posterior limb internal capsule | Sensory |
| Anterior 2/3 of posterior limb internal capsule | Motor |
| Releasing factors | Recognize stop codons UAA UGA UAG and terminate protein synthesis, facilitating release of polypeptide chain from ribosome and dissolution of ribosome mRNA complex |
| Major Virulence factor HIB | Polyribosylribitol phosphate (polysaccharide capsule), protects from phagocytosis and complement lysis by binding factor H, a circulating complement control protein that prevents complement deposition on host cells |
| M protein | Cell wall of strep, binds factor h to prevent opsonization and destruction by alternative complement pathway. Also molecular mimicry, may underly immune response in rheumatic fever |
| Cyp450 methylation | Azathioprine ,6MP |
| Abd aortic aneurysm path | Factors lead to chronic transmural inflammation and extracellular matrix degeneration of wall of aorta. Aneurysm is typically below renal arteries |
| Nfkb | Proimflammatory transcription factor that increases cytokine production. In crohns, NOD2 mutation (microbial receptor) means less nfkb activity, impairing immune response of intestine, allowing bacteria to penetrate submuclsa, causing exag response |
| Urine acid buffers | Hpo4, nh3( more important ) |
| Brown pigment stone | Bc infx - results in release of beta glucuronidase by injured hepatocytes and bacteria. Hydrolyzes bilirubin glucuronides and increases the amount of unconjugated bilirubin. |
| Nephrogenic DI treatment | HCTZ, amiloride, indomethacin. Can be caused by lithium!! |
| Thyroid biopsy shows Tall follicular epithelial cells, scalloped colloid | Graves disease |
| Antimicrosomal antibodies | Aka anti thyroid peroxidase- hashimotos thyroiditis |
| Cause of death diabetes | MI |
| RET mutation | Men 2a 2b, codes for receptor tyrosine kinase |
| DNA binding motifs | Leucine zipper, zinc finger helix loop helix |
| Cd16 | Fc receptor, Immature neutrophils have less so it's a sign of left shift |
| Small cell lung cancer paraneoplastic syndromes | Adh, acth, pthrp, paraneoplastic cerebellar degeneration, paraneoplastic encephalomyelitis, lambert Eaton myasthenic syndrome, opsoclonus myoclonus ataxia syndrome |
| Thymoma paraneoplastic syndromes | Pure red cell aplasia, good syndrome (hypogammaglobulinemia), myasthenia gravis |
| Ovarian teratoma paraneoplastic syndrome | Anti NMDA receptor encephalitis p |
| TNF a | Secreted by macrophages, activated endothelium, causes WBC recruitment, vascular leak. Causes cachexia in malignancy, maintains granuloma in TB, can mediate sepsis w il1,6 |
| IFN gamma | Secreted by th1 cells and NK cells in response to antigen or IL12 Fromvmacrophages; stimulates macrophages to kill phagocytosed pathogens, increased MHC expression and antigen presentation on all dells. Inhibits th2 differentiation |
| IFN alpha and brta | Innate host defense- glycoproteins synth by virus infected cells that act locally on uninflected cells, priming them for viral defense by helping to degrade viral nucleic acid and protein |
| Frataxin | Iron binding protein, defect leads to impairment in mitochondrial functioning. In friedreich ataxia |
| Charcot Marie tooth disease | Aka hereditary motor and sensory neuropathy - group of disorders w defective production of proteins involved in structure and function of peripheral nerves or myelin sheath. AD, pes cavus, hammer toe, foot drop, sensory def |
| Krabbe disease | AR Buildup of galactocerebrosidase and psychosine destroy myelin sheath- peripheral neuropathy, developmental delay, optic atrophy, globoid cells |
| Metochromaic leukodystrophy | AR, impaired production and destruction of myelin sheath- central and peripheral demyelination with ataxia and dementia |
| Myotonic type 1 | CTG trinucleotide expansion in DMPK gene- abnormal expression of Myotonin protein kinase- myotonia, muscle wasting, cataracts, testicular atrophy, frontal balding, arrhythmia. My tonia.. |
| Lamellar bodies | How the type 2 pneumocytes secrete surfactant! |
| Antiproteinase 3 | Wegners granulomatosis |
| Anti myeloperoxidase | Microscopic polyangitis |
| MELAS | mitochondrial inheritance: mitochondrial encephalopathy, lactic acidosis, stroke like episodes). Heteroplasmy!! |
| Measure reinfarction use | CK-MB- goes down in 72 hours. Don't use troponins bc they can stay high for 7-10 days! |
| Hemosiderin laden macrophages | Heart failure cells- increased pulm venous pressure causes rupture of capillaries- blood leaks into alveolar air sacks, macrophages eat it |
| Anitschkow cells | Enlarged macrophages with ovoid wavy caterpillar like nucleus in Aschoff bodies in ARF |
| Endocarditis with negative blood cultire | HACEK- haemophilus, aggregatibacter (formerly actinobacillus), cardiobacterium, eikenella, kingella). |
| Endocarditis fibroelastosis | Dense layer of fibrosis in endocardium causing restrictive cardiomyopathy, classically seen in children |
| Loffler syndrome | Eosinophilic infiltrate with inflammation in wall of heart - fibrosis of endocardium and myocardium. Get restrictive cardiomyopathy |
| Low voltage ECG | Restrictive/infiltrative cardiomyopathy (postradiation fibrosis, loffler syndrome, endocardial fibroelastosis, amyloidosis, sarcoidosis, hemochromatosis (dialated more common though) |
| Osler Weber rendu syndrome | Hereditary hemorrhagic telangiectasia- blanching skin lesions, recurrent epistaxis, skin discolorations, AV malformations, Gi bleeds hematiria |
| Fibromuscular dysplasia | Renal artery stenosis in young females- get stenosis and anyeurisms- string of beads appearance! |
| Liver angiosarcoma | Associated with polyvinyl chloride, arsenic. Highly aggressive |
| Kaposi sarcoma | Tumor of endothelial cells (not full vessels, does not blanch), HHV8 HIV, older Eastern European males, transplant recipients. Lymphocytic infiltrate |
| Bacillary angiomatosis | Capillary skin papules, benign, Bartonella henselae, neutrophilic infiltrate, AIDS |
| Orbital hypertelorism, submucous cleft palate, bifid uvula, tetralogy or truncus etc | Velocardiofacial syndrome- 22q11.2 micro deletion, like digeorge. Test with FISH |
| Cd 15 | On granulocytes and reed sternberg cells- useful in diagnosis of hodgkins (also CD 30 positive) |
| Isolated systolic HTN | Increased arterial stiffness, increased CO bc severe aortic regurg, anemia, hyperthyroidism |
| Alpha 1 receptor target organs | Peripheral vasculature, eye , bladder |
| Akathesia | Subjective restlessness with inability to sit still. Antipsychotic side effect |
| Tardive dyskinesia | Involuntary movements after chronic use of antipsychotics (lip smacking, choreoathetoid movements |
| ALA synthase upregulated by | CYP450 inducers- barbiturates, anti epileptics, ETOH, smoking, griseofulvin, rifampin |
| Where does renal cell carcinoma metastasize | 1. Lung 2. Bone |
| Triad above superior thyroid gland | Superior thyroid artery, vein, and external laryngeal nerve (branch of superior laryngeal, innervates cricothyroid which tenses vocal cords, damage causes low hoarse voice |
| Muscle dysfunction in zenker diverticulum | Cricopharyngeal |
| Phosphorylase kinase | Activates glycogen phosphorylase . In muscles Activated by primarily by increased calcium (less so by epinephrine which increases camp) and in liver activated by increased camp by epinephrine and glucagon |
| Down syndrome increases risk of | Duodenal atresia, hirschsprung disease, ALL, AML, av septal defect (endocardial cushion defect), VSD ASD |
| Marjolins ulcer | Aggressive ulcerating SCC in area of previously traumatized chronically inflammed or scarred skin, 10 years post trauma |
| Mean +- 1.96SD/sr(n) | 95 percent confidence interval . 2.58 x SE= 99% |
| Wilsonsndisease copper deposits in | Basal ganglia (lentiform nucleus) |
| Acne elements | 1. Follicular epidermal hyperproliferation. 2. Excessive sebum production. 3. Inflammation. 4. Propionibacterium acnes |
| 2 ways leptin decreases food intake | Decreased production of neuropeptide y(appetite stimulant) in arcuate nucleus, and production of POMC in actuate nucleus, which. Is cleaved into alpha melanocyte stimulating hormone and inhibits food intake |
| Suprapatellar bursitis | Direct blow to distal thigh or prolonged repetitive quadriceps activity (running) |
| Pyrrilidonyl arylamidase | Positive = strep pyogenes |
| Adiponectin | Cytokines secreted by fat tissue that increases the number of insulin responsive adipocytes and stimulates fatty acid oxidation |
| Anopheles mosquito | Malaria |
| Micturition reflex spinal cord lecels | S2-S4 |
| Idiosyncratic drug reaction | Unpredictable reaction due to genetic differences or complex metabolic interactions (e.g. G6PD def and primaquine) |
| Vitamin b6 used in | 1. Oxalate stones bc hyperoxaluria- decreases endogenous oxalate production 2. Homocysteinuria- increases breakdown to cystathionine |
| Leber hereditary optic neuropathy | Mitochondrial inheritance, progressive bilateral optic neuropathy leading to blindness |
| Rett syndrome | X linked dominant, affects females bc males die in utero. Stereotypic hand wringing movements, neurodegeneration |
| Scotomas caused by | Macular degeneration |
| Binasal hemianopsia | Calcified carotid arteries |
| Base excision repair | Repairs depurination, alkylation, oxidation, deamination. Excessive dietary nitrites can promote deamination. Glycosylase endonuclease lyase polymerase ligase |
| Thalamic syndrome | Contralateral burning or stabbing pain over one side of body, due to damage to thalamus |
| Vimentin positive | Mesenchymal tumors- Sarcoma, RCC, meningis |
| Small cell carcinoma markers | Neural cell adhesion molecule, neuron specific enolase, chromogranin, synaptophysin |
| 2 things upregulated lac operon | 1. Low glucose -> increase camp -> activate cap 2. High lactose -> unbound depressor protein from operon |
| When do you have nucleotide excision repair, MMR, BER | G1, g2, all |
| P bodies | Cytoplasm, have exonucleases, decapping enzymes and microRNA, mRNA may be stored here for future translation. Quality control |
| Trna charging verses protein synth energy | ATP activation , GTP- gripping, going places |
| Desmin | Muscle marker- rhabdomyosarcoma p |
| Cytokeratin | Epithelial tumors like SCC |
| GFAP | neuroglia- astrocytoma, glioblastoma |
| Neurofilament stain | Neuronal tumors- neuroblastoma |
| Osteogenisis imperfecta | COL1A1 and 2, most common form AD, decreased production of otherwise Normal type 1 collagen. Bone fractures, blue sclera, dental imperfections, hearing loss Problems forming triple helix (glycosylation step) |
| Ehlers danlos | Classic: mutation type 5 collagen (COL5A1,2)- joint and skin symptoms. Hypermobility type: joint instability, most common. Vascular type: vascular and Organ rupture- type III collagen deficiency |
| Menkes disease | ATP7A, X linked recessive, impaired copper absorption and transfer- decreased Lysol oxidase activity so cross linking defect. Brittle kinky hair growth retardation hypotonia |
| Allelic hererogeneity | Different mutations at same locus produce same phenotype |
| Trinuclotide repeat expansion diseases | Huntingtons (CAG), myotonic dystrophy (CTG), fragile x (CGG), Friedreich ataxia (GAA) |
| Marasmus | Malnutrition not causing edema- diet deficient in calories but no nutrient absent entirely- muscle wasting |
| Kwashiorkor | Protein malnutrition resulting in skin lesions (hyperkeratosis, hyperpigmentation), edema, liver malfunction (fatty), anemia |
| Transaminase reactions use | B6 |
| Nadph used for | Anabolic processes ( steroid and FA synth), respiratory burst, CYP450, glutathione reductase |
| What chain fatty acids can produce glucose | Odd chain only- can produce 1 propionyl coA. Even chain can only make acetyl coA so can't be used for gluconeogenisis |
| Smudge cell | CLL |
| CLL marker | Cd5 and cd20. (Cd5 is usually T cell marker!) |
| What part of spleen expands hairy cell leukemia | Red pulp!!! Unusual , normally with leukemias you expect white pulp to get big. You also don't get lymphadenopathy here |
| 2-CDA | Adenosine deaminase inhibitor- adenosine accumulates to toxic levels in neoplastic B cells. Use in hairy cell leukemia! |
| Bloody nipple discharge | Intraductal papilloma. Slight increased risk for cancer |
| Developmental field defect | Initial embryonic disturbance leads to multiple malformqtionsnby disrupting development of adjacent tissues and structures in particular region. Example is holoprocencephaly |
| Association defect | Multiple anomalies without known unifying cause that occur together more frequently than chance alone would predict. E.g. VACTERL (all mesodermal) |
| Beta hydroxybutyrate | A ketone body |
| DMARDS | Methotrexate, sulfasalazine, hydroxychloroquine, minocycline, TNFa inhibitors |
| Myotonia | Abnormally slow relaxation of muscles |
| Ubiquitin proteasome complex | Parkin, PINK1, DJ1 . Mutations are associated with autosomal excessive forms of Parkinson's with early onset |
| Korsakoff syndrome | Damage to anterior and dorsomedial thalamic nuclei- confabulation, memory loss , anterograde amnesia. Usually permanent |
| Who's at risk for drug induced lupus | Slow acetylators- isoniazid, hydralazine, procanimide |
| B4 used to make | Tyrosine dopa serotonin and NO |
| Major basic protein | Cytotoxin released by eosinophils in a type II hypersensitivity response, binding to igE. Also produce histaminase, eosinophils perpxidase, eosinophil catatonic protein, and eosinophil derived neurotoxin. See increased MBP in csf in multiple sclerosis |
| Nitroprusside | Decreased preload and afterload |
| Nitroblue tetrazolium | Test for chronic granulomatous disease |
| Polycistronic mRNA | Single mRNA codes for multiple proteins, common in procaryotes e.g. Lac operon |
| Serotonergic neurons found in | Raphe nucleus |
| Secondary bacterial pneumonia | S pneumo> s aureus> h flu |
| Aqueous humor produced by | Epithelial cells of ciliary body |
| Tachyphylaxis | Rapidly declining effect of a drug after few days- seen with decongestants (alpha agonists) , nitroglycerin |
| Passive congestion of the spleen | Portal hypertension, splenic vein thrombosis, congestive heart failure |
| Monocytes names | Kupffer cells- liver, osteoclasts-bone, microglial cells- CNS, mesangial dells- kidney, alveolar macrophages- lung, langhans- multinucleated giant cell in granulomatous inflammation p |
| Complications of pagets | High output cardiac failure, increased risk osteosarcoma |
| Achondroplasia mutation | Constitutive activating mutation of Fibroblast growth factor receptor FGFR3 which inhibits chondrocyte proliferation. Usually sporadic mutation. Defect in endochondrial ossification |
| Osteopetrosis mutation | Carbonic anhydrase II Mutation, can get Renal tubular acidosis |
| Gardner syndrome | FAP, Osseus and soft tissue tumors (osteoma) congenital hypertrophy of retinal pigment epithelium, impacted/supernumerary teeth |
| Turcot syndrome | FAP/lynch syndrome + malignant CNS tumor (medulloblastoma, glioma) |
| Osteoma | On facial bone , associated with Gardner syndrome |
| Osteoblast tumors | Osteoid osteoma (cortex of long bones diaphysis, get osteoid surrounded by reactive bone, pain resolves with aspirin), osteoblastoma (larger, vertebral, bone pain that doesn't respond to aspirin), osteosarcoma (Rb, pagets, li fraumeni) |
| Osteoclast tumors | Giant cell tumor (soap bubble, epiphysis) |
| Pliomorphic cells producing osteoid | Osteosarcoma |
| Pannus | In RA, Proliferation granulation tissue bc synovitis with blood vessels fibroblasts myofibroblasts- get joint deviation, destruction of articular cartilage |
| Rheumatoid factor | IgM against Fc portion of IgG |
| Ankylosing spondylitis | Ankylosis (joint fusion of spine and sacroiliac joints ), uveitis, aortitis-> aneurysm and aortic regurg |
| Largest protein coding human gene | Duchennes! It's x linked but also commonly spontaneous |
| Sarcoma botryoides | Embryonal rhabdomyosarcoma variant, young girls vaginal tumor, clear grape like polyploid mass emerging from vagina, Desmin+ |
| Fascications | LMN sign |
| Lymph node expansion. | Follicles- RA, HIV, Paracortex- viruses, sinus histiocytes- draining cancer |
| Lack of tingible body macrophages in germinal center | Follicular lymphoma |
| Hodgkin lymphoma subtypes | Nodular sclerosis- most common, pink bands of fibrosis, lacunar reed sternberg cells. Lymphocyte rich- best prognosis. Mixed cellularity- eosinophilia (increased IL5), lymphocyte depleted- worst prog |
| Increased IL6 cancer | Multiple myeloma |
| S100 and CD1a positive | Lagerhans cell histiocytosis |
| Waldenstrom macroglobulinemia | IgM increase- blurred vision, raynaud. No crab findings |
| Multiple myeloma | IgG>IgA. hyperCAlcemia, Renal involvement (bench jones proteins), Anemia (also see rouleaux formation), Bone lyric lesions (produce osteoclast activating factor) |
| Pseudo pelger huet anomaly | Neutrophils with bilobed nuclei, typically seen after chemotherapy |
| Erythema multiforme | Cd8 mediated, post HSV, mycoplasma, drugs , cancer, autoimmune disease. Severe cases can affect oral mucous membranes. Target lesjon |
| Mutation in genes that repair interstrand DNA cross links | Fanconi anemia |
| Lymph from testes drains to | Paraaortic lymph nodes (retroperitoneal) |
| Lymph from glans penis and cutaneous portion of posterior calf drains to | Deep inguinal lymph nodes . Superficial inguinal also drain here |
| Rhodanese | Metabolizes cyanide in tissues by transferring sulfur to cyanide to form thiocyanate (less toxic, renal excretion) Cyanide overdose (nitroprusside)- depleted available sulfer donors. Give sodium thiosulfate, sodium nitrite, b12 |
| Urinary deoxypyridoline | Released into circulation when bone reabsorbed by osteoclasts - pyridinoline covalently cross links collagen fibers |
| Trypsin inhibitors | 1. Serine peptides inhibitor kazal-type 1 (SPINK1) secreted by acknar cells, impedes prematurely activated trypsinogen molecules 2. Trypsin can inhibit itself via cleavage |
| Serum protease inhibitor | Alpha 1 antitrypsin- normally inhibits elastase |
| Pregnancy gallstone | 1. Estrogen- upregulates HMGCOA reductase, supersaturates bile with cholesterol 2. Progesterone slows gallbladder emptying, reduces bile acid secretion |
| Ppar- gamma effects | Binds retinoid X receptor, complex binds DNA and upregulates GLUT4 receptors (insulin sensitivity), adiponectin, increases fatty acid uptake, decreases TNFa, decreases leptin |
| Bosentan | Endothelin receptor antagonist, used for primary pulmonary hypertension |
| Mycobacterium catalase peroxidase non expression = resistance to | Isoniazid (gets processed by it) |
| Peyronie disease | Excess collagen formation within tunica albuginea caused abnormal curvature of penis, pain |
| Norepinephrine extravasation | NE Leak during iv drip causes intense vasoconstriction which can lead to local tissue necrosis. Give phentolamine |
| Nadh methemoglobin reductase | Reduces ferric iron (3+) to ferrous iron (2+), regenerating hemoglobin from methemoglobin. Enzyme deficiency results in congenital methemoglobinemia |
| Lymphocytic sialadenits | Sjogren syndrome- lymphocytes attacking salivary glands |
| Hepatic stellate (ito) cells | In space of disse, store vitamin A when quiescent and produce extra cellular matrix when activated |
| Erythemas | Marginatum- ARF, multiform- infx like mycoplasma, HSV, drugs cancer autoimmune dz, migrans- Lyme disease, nodosum- shins sarcoidosis coccidiomycosis histo TB strep leprosy IBD |
| Enteropeptidase/enterokinase | Converts trypsinogen to trypsin at brush border |
| Angiofibroma | Benign tumor of nasal mucosa, large vessels and fibrous tissue, cause of epistaxis. Only seen in adolescent males |
| Nasal polyps | Cystic fibrosis , aspirin induced asthma, allergic rhinitis( repeated) |
| Laryngeal papilloma | Benign papillary tumor of vocal cord, hpv 6/11. Single in adults multiple in children, presents with hoarseness |
| Treatment for serotonin syndrome | Cyptoheptadine - serotonin antagonist |
| Recurrent lobar hemorrhagic stroke in elderly | Cerebral amyloid angiopathy |
| Tertiary prevention | Treating an established condition with goal of minimizing progression or complications |
| Lactose fermenting rods | Enterobactr ( indole negative ), ecoli (indole positive), klebsiella. Citrobacter and serratia are slow fermenters |
| Hox genes code for | Transcription factors |
| Seborrheic dermatitis | Chronic inflammatory condition w accumulation of scaly greasy skin on scalp face ears eyelids eyebrows. HIV or Parkinson's |
| Antismooth muscle antibody | Autoimmune hepatitis |
| Straining phase of valsalva | Decreases venous return to heart |
| Transpeptidase example | Penicillin binding protein |
| Wolff chaikoff effect | Excess iodine temporarily inhibits thyroid peroxidase-> decreased iodine organification, decreased T3/4 production |
| Omaphalomesenteric duct | Aka Vitelline duct |
| Erythromycin | Used to stimulate intestinal peristalsis (motilin receptor agonist) |
| Aldose reductase | Converts sugars into their corresponding alcohols |
| Alpha 1 antitrypsin mutation | Accumulation of globules in the ER of liver , PAS positive. Misfolded. PIZ most common mutation. Heterozygous- increased risk w smoking. homozygous- panacinar emphysema. PIM is normal |
| Caplan syndrome | Coal workers pneumoconiosis + rheumatoid arthritis |
| Anthracosis | Asymptomatic bc of pollution, get carbon laden macrophages in lung p |
| Silicosis | Impaired formation of phagolysosomes- increased risk of TB. |
| Risk factors for neonatal respiratory distress syndrome | Prematurity, c section, maternal diabetes (insulin inhibits surfactant production). Can be complicated by PSA, necrotizing enterocolitis (bc decreases oxygen in gut ) |
| Surfactant primarily made of | Dipalmitoylphosphatidylcholine (the primary lecithin) |
| Where does lung cancer metastasize | ADRENALS, brain, bone, liver |
| Bartholin cyst | Unilateral painful cystic lesjon at the lower vestibule adjacent to the vaginal canal |
| Lichen sclerosis | Parchment like vulvar skin- thinning of epidermis and fibrosis of dermis. Benign, but associated w slight increase in risk of SCC |
| Lichen simplex chronicus | Thick leathery skin of Vulca bc of chronic irritation. No increased risk of cancer |
| DES exposure | Get adenosis- persistence of columnar cells in top 2/3 of vagina (meullerian duct derived ), increases risk for clear cell adenocarcinoma |
| Vaginal cancer lymph nodes | Top 2/3- meullerian duct- columnar- regional iliac nodes Lower 1/3- urogenjtal sinus- squamous cell- inguinal lymph nodes |
| Amaurosis fugax | Painless transient monocular vision loss caused by small embolus in ophthalmic artery. Usually doesn't last more than few seconds |
| Chronic endometreitis | CharacteriZed by plasma cells in endometrium |
| Endometrial carcinoma | 1. Hyperplastic- younger patients 2. Serous- sporadic older patients, p53 mutations, papillary, can get psamomma bodies |
| Most common somatic malignancy in mature teratoma | Squamous cell carcinoma of the skin of the teratoma |
| Struma ovarii | Thyroid tissue in mature teratoma! Hyperthyroidism |
| Endodermal sinus tumor | Aka yolk sac tumor, Schiller duval bodies (like glomeruli ), seen in kids. AFP is tumor marker |
| Dysgerminoma | Fried eggs. HcG and LDH |
| Reinke crystals | Leydig cell tumors, eosinophilia cytoplasmic inclusions |
| Pseudomyxoma peritonei | Massive amounts of mucus, primary tumor of appendix. Has metastatic potential to ovary |
| Theca luteal cysts | Associated with gonadotropin stimulation (hCG). So associated w molar pregnancy, choriocarcinoma. |
| Bifid carotid pulse with brisk upstroke | HCM |
| Excessive skin at nape of neck | Down syndrome p |
| DNA repair problems /susceptibility | Ataxia telang- hypersensitivity to ionizing radiation. Xeroderma- UV radiation. Fanconi- cross linking agents. Bloom- chromosomal instability. Lynch- MMR |
| Aspirin intox | 1. Respiratory alkalosis- stimulates respiratory center causing hyperventilation 2. Anion gap acidosis |
| Estrogens | Adipose tissue- estrone, placenta -estriol, ovary- estradiol. Potency : estradiol> estrone> estriol |
| FGF23 | Released by osteocytes and osteoclasts in response to hyperphosphatemia decreased PCT phosphate reabsorption, reduces calcitrol synthesis (active vitamin d) |
| Where is andeogen syntj in females | Theca INTERNA |
| Human placental lactogen | Aka chorionic somatomammotrophin. Made by syncytiotrophoblast of placenta, stimulates insulin production, increases insulin resistance due to shunting carb metabolism towards supplying glucose/amino acid to fetus |
| Positive trendelenburg sign | Superior gluteal nerve injury bc superiomedial buttocks injury. Medius and minimus. Lean towards affected side to minimize hip drop |
| Lymphogranuloma venerum | Chlamydia type L123- small painless ulcers on genitals -> swollen painful inguinal lymph nodes that ulcerate ( buboes) |
| MAC depends only on | Body temperature and age (decreases w increasing age ) |
| Tc-pertechnate scan | Affinity for parietal cells of gastric mucosa, if increased uptake in RLQ periumbilical region = meckels diverticulum |
| Hepatic encephalopathy | Primary source of ammonia is breakdown of nitrogen products by intestinal bacteria - excess dietary protein or GI bleeds can trigger HE, so can infx, sedatives, metabolic derangement (hypokalemka). Treat w lactulose( ammonia-> ammonium), rifaximin |
| Nonbacterial thrombotic endocarditis | Get sterile platelet rich thrombi. Associated with advanced malignancy, chronic inflammatory disorders (antiphospholipid syndrome, SLE), DIC in patients w sepsis. Compared to I.E., the lesions easily dislodge/more likely to embolize causing infarct |
| Hepatitis E | Unenveloped ssRNA virus, fecal oral |
| Supraoptic and paraventricular nuclei | Project to posterior pituitary- ADH, oxy |
| Calories | 4 protein/carb, 9- fat |
| KIT | Oncogene, gastrointestinal stromal tumor |
| Hartnup disease | AR, inactivating mutation in neutral amino acid transporter- impaired transport of neutral amino acids , particularly tryptophan, in small intestine and proximal tubule. Pellegra symptoms, cerebellum ataxia |
| Benign calcifications in breast | Sclerosing adenosis l, fat necrosis, mockenbergs medial calcification |
| Osteoprotegerin | Physiologic decoy receptor that decreased binding of RANK-L to RANK, reducing differentiation and survival of osteoclasts. LOF mutation cause juvenile pagets |
| SCC paraneoplastic syndrome | PTHrP |
| Adenocarcinoma associated w | Trousseau syndrome, nonbacterjal thrombotic endocarditis (esp pancreatic) |
| Actuate fasciculus | Connects Broca and wernickes areas |
| Ringed sideroblasts | Seen in bone marrow but not in peripheral blood smear |
| Cryptordism | Normal testosterone bc leydig cells mostly unaffected, decreased inhibin increased fsh lh |
| Myositis ossificans | Conversion of skeletal muscle into bone post trauma |
| Pancreatic cancers arise from | Ducts |
| Pericarditis ECG | widespread st elevation |
| Filgastrim | Gcsf |
| Osgood Schlatter | Overuse injury of secondary ossification center (apophysis) of tibial tubercle, at insertion of patellar ligament . Can be bc repetitive quad contraction |
| Baroreceptors | Decreased firing with hypotension, increased firing with hypertension |
| TBG levels | Decreased in hepatic failure and steroids, increased in pregnancy, OCP use (bc estrogen!) |
| Androgen insensitivity syndrome | Female genitalia, rudimentary vagina, no pubic hair, normal testes (often in labia majora), increased testosterone, estrogen, LH( can't sense high t) |
| Hepatoduodenal ligament | Contains the portal triad- common bile duct portal vein hepatic artery |
| Low ID50 | Shigella campylobacter entamoeba histolitica, giardia |
| Licorice | Can cause syndrome of apparent mineralocorticpid excess bc it has glycyrrhetinic acid which inhibits cortisol-> cortisone (no activity on mineralocorticoid receptors) |
| Brain tumor findings | Homer right wrosettes- medulloblastoma , pseudorosettes- ependymoma, rosenthal fibers-pilocytic astrocytoma |
| Hypersensitivity pneumonitis | Mixed type 3/4. See noncaseating granulomas and eosinophils |
| Myoedema | Focal mounding of muscle following percussion, secondary to slow reabsorption of ca by sarcoplasmic reticulum, see elevated ck. Cause is HYPOTHYROID |
| Systemic sclerosis antibodies | Antitopoisomerase (scl70), anticentromere, anti rna polymerase III |
Created by:
Laila.foz