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Vasospasm vs rebleeding after subarachnoid hemorrhage Vasospasm occurs 3-12 days after and CT usually remains unchanged Rebleeding occurs soon after (<24 hours) and results in changes in CT
MC benig liver tumor (+microscopy) Cavernous hemangioma Micro: Cavernous blood filled vascular spaces lined by a single epithelial layer
2nd generation antipsychotics Block 5-HT2A receptors and have lower binding affinity to D2 receptor sites = lower risk of extrapyramidal side effects.
Individuals on vegan diets are deficient in> Calcium and vit D
When does field cancerization occurs? When a large area of cells is exposed to carcinogens that induce mutations (Common in mucosal head and neck squamous cell carcinoma).
Topical immunomodulatory agent that stimulates potent cellular and cytokine based immune response by activating TLRs on aberrant cells (like HPV infected cells) Imiquimod Inhibits angiogenesis. Induces apoptosis
Common cause of nephrotic syndrome in adults in the setting of malignancy, SLE and viral hepatitis Membranous glomerulopathy
Decompensated HF is a common cause of secondary> Mitral valve regurgitation
Used to detect and quantify levels of mRNA of a sample RT-PCR Used to diagnose CML
The probability that a sibling would be an identical HLA match is: 1/4 (Each individual gets 2 HLA halotypes from each parent)
Complications of hereditary spherocytosis Pigmented gallstones and aplastic crisis due to parvovirus b19
Colonic diverticula form in areas where> Weak points of the colonic wall, where the vasa recta penetrate through the smooth muscle.
What is the Reid index? Ratio of the thickness of the submucosal bronchial glands to the thickness of the bronchial wall between the epithelial membrane and the bronchial cartilage.
Rotavirus infection causes diarrhea via multiple mechanisms including> Villous blunting, proliferation of crypt cells and reduced brush border enzymes.
Rotavirus invades> The villous epithelium of the duodenum and proximal jejunum
Watery diarrhea without fecal leukocytes in an unvaccinated child Rotavirus
Test specificity Ability to correctly identify individuals without a disease true negatives/ (true negatives+ false positives)
Hypovolemia (effects on renal physiology) Reduced RPF Reduced GFR Increased FF (compensatory arteriolar vasoconstriction)
Adhesion of cells to the extracellular matrix involves: Integrin mediated binding to fibronectin, collagen and laminin. Adhesion properties defects seen in numerous malignancies (melanoma)
Polyarteritis nodosa (PAN) is often associated with underlying> Viral hepatitis B and C PAN: Constitutional manifestations and ischemic symptoms in the kidneys, skin, GI tract and neurologic system.
The tissue tropism of viruses is primarily mediated by... And mutations can result in> Mediated by viral surface glycoproteins that bind to host cell receptors. Mutations can cause non infectious viruses to become infectious.
Can improve spasticity without paralysis Selective dorsal rhizotomy (Disruption of the afferent sensory arm of the stretch reflex)
Urine sediment in acute ureterolithiasis usually shows> Free RBCs (hematuria) and crystals consistent with the type of stone.
Glycogen formation is stimulated by increased levels of> Insulin and glucose-6-phosphate *A rise in fructose-2-6-bisphosphate in hepatocytes concurs with a rise in glycogen synthesis and decreased gluconeogenesis. (X Alanine>glucose)
Causes of premature cataracts formation> Systemic or ophthalmic glucocorticoid use, DM, ocular trauma and external radiation exposure.
The infusion of excessive normal saline (sodium chloride) is a common cause of> Non anion gap metabolic acidosis Excess chloride causes intracellular shifting of bicarb to reduce serum bicarb and lower blood pH.
Can cause SIADH by increasing ADH secretion and renal ADH sensitivity Carbamazepine
SIADH presents with> And is the opposite of > Hypotonic hyponatremia (low serum osm and Na) , concentrated urine (high urine osm) , and euvolemia. The opposite of nephrogenic diabetes insipidus.
Beta blockers act as competitive inhibitors of > Toxicity presents with> Endogenous catecholamines Hypotension, bradycardia, bronchospasm, hypoglicemia.
Can be co-administered with dopamine receptor blockers to prevent excessive cholinergic activity in the treatment of severe migraine. Diphenhydramine
Is a proto-oncogene often activated in tumor cells, thereby increasing the cellular response to mitogenic stimuli KRAS
Stimulate cell proliferation and their over-expression/amplification leads to increased cell proliferation and neoplastic growth Proto-oncogenes KRAS, ALK, C-MYC, RET, BRAF, BCL-2...
Patients with acute decompensated HF are treated with> Place of action on the nephron> Loop diuretics (inhibit Na-K-2Cl) Thick ascending limb of loop of Henle
The replacement of enzymes needs to be administered via > IV, because enzymes are very large proteins that can't be absorbed orally. (Exception in pancreatic insufficiency, PO) Entry into the cell occurs via endocytosis after the replacement enzyme binds to receptors on the cell surface.
Follicles clogged with sebum provide the anaerobic, lipid rich environment for the growth of> Propionibacterium acnes
Results in a blowing holosystolic murmur best heard over the cardiac apex with radiation to the axila> Mitral regurgitation Caused by rheumatic fever, specially in underdeveloped countries.
Commonly occurs in response to systolic dysfunction or certain types of valvular disease Dilation of the left ventricular cavity. Heart failure decompensation.
Low fecal elastase, sudan staining and elevated Hb A1c all support the diagnosis of> Chronic pancreatitis
Benign, fluid filled masses that occur due to mucoid degeneration of periarticular tissue and present as painless, smooth masses that transilluminate. Ganglion cysts Most resolve spontaneously.
Examples of active transport carriers> Drugs that can inhibit it> Na/K ATPase H/K ATPase Ca ATPase Omeprazole and others PPIs inhibit active transport due to their action on H/K ATPase.
Contain high levels of mitochondria, lipids and myoglobin. Their function is amplified by endurance training. Type I, slow-twitch/ Red muscle fibers.
This meningitis is characterized by the formation of a thick, gelatinous exudate at the base of the brain, cerebral vasculitis and hydrocephalus> TB meningitis Presents with subacute, slowly progressive nausea, vomiting, fever, cranial nerve deficits and stroke.
Indirect indicators of chronic alcohol consumption> 1) Macrocytosis 2) AST: ALT ratio>2
Is a drug combination effective agains most gram- enteric rods. Even the ones with beta lactamase activity> Piperacillin-tazobactam (Tazobactam is a beta lactamase inhibitor)
Person legally designated to make medical decisions if a patient loses decision making capacity, overrules all other surrogates. Health care proxy
Changes during pregnancy: SVR, plasma blood volume SVR decreases (due to increased release of peripheral vasodilators) Plasma blood volume increases (RAAS activation leading to fluid retention)
Anterior cord syndrome, affected tracts and manifestations> Bilateral distal loss of pain , temperature and crude touch sensation (from injury of spinothalamic tracts) and paralysis (from injury of lateral corticospinal tracts)
Increased liver lipoprotein production during minimal change disease is triggered by> Low oncotic pressure
Is a common consequence of myocardial infarction affecting the left ventricle> What causes it? Acute pulmonary edema. Increased hydrostatic pressure in the pulmonary venous system leads to engorged alveolar capillaries with fluid transudation (acellular pink material on histology).
Two allele loci are said to be in linkage disequilibrium when> When a pair of alleles are inherited together in the same gamete (haplotype) more or less often than expected by chance alone. Often the result of physical proximity of genes.
Rupture of cortical bridging veins causes> Subdural hematoma After fall or accidents in young patients, after minor trauma in elderly.
What is biliary sludge? What does it cause? Concentrated, viscous bile due to hypomotility. Causes biliary colic, and promotes cholesterol stones formation.
Digital clubbing is associated with> Prolonged hypoxia. Patients with lung cancer, TB, CF, empyema, bronchiectasis and chronic lung abscesses.
Iron deficiency anemia may result in which nail finding? koilonychia (spoon-shaped nails)
Alzheimer disease specific treatment> Cholinesterase inhibitors (donepezil) Antioxidants ( vit E) NMDA receptors antagonists (memantine)
Pregnant women can develop GERD due to> Elevated levels of estrogen and progesterone decrease the muscle tone of the LES. Later in pregnancy can happen due to uterus pressure on the stomach.
Primary mechanism underlying cytotoxic early edema following cerebral ischemia> Accumulation of intracellular Na+ and water due to failure of ATP dependent ion transporters.
Increased hydrostatic pressure following central venous thrombosis or hypertensive encephalopathy can cause> Cerebral edema and high ICP. Patients first develop gradually worsening headache before presenting neurologic abnormalities.
Is responsible of the physiologic adaptations in hypothermia> The sympathetic nervous system.
Is a tyrosine kinase receptor that is overexpressed in 20% of breast cancer patients> HER2
Trastuzumab Monoclonal antibody that blocks HER2, downregulates cellular proliferation and promotes apoptosis.
Biopsy of salivary glands in patients with Sjogren syndrome> Periductal lymphocytic infiltrates often with germinal centers
4 Major elements that underlie the pathophysiology of acne> Follicular epidermal hyperproliferation (androgens, anabolic steroids) Excessive sebum production Inflammation Propionibacterium acnes
Most common triggers of drug induced hemolysis> Anti-inflammatory medications, penicillins and cephalosporins
HAART for HIV is commonly associated with> Body fat redistribution Subcutaneous lipoatrophy involving the face and extremities linked to nucleoside reverse transcriptase inhibitors (stavudine, zidovudine) and protease inhibitors.
Area of the brain that demonstrates higher degree of atrophy in Alzheimer's disease Hippocampus
Pheochromocytoma immunohistochemistry is positive for> Synaptophysin, chromogranin and neuron-specific enolase.
Celiac disease is characterized by> Increased intraepithelial lymphocytes, variable loss of villus hight and crypt hyperplasia. All resulting in malabsorption.
Biopsy of the affected tissue is necessary to confirm the presence of these fungi> Mucor and Rhizopus.
Chancroid is caused by> Haemophilus ducreyi "So painful you do cry"
Turbulent flow across a small VSD produces a> Loud holosystolic murmur best heard over the lower left sternal border.
Increased O2 saturation between two right-sided vessels or chambers indicates de presence of> A left to right shunt.
Early marker of abnormal phosphorus metabolism in patients with chronic kidney disease. Fibroblast growth factor 23 (FGF23) Reduces intestinal absorption and renal reabsorption of phosphate.
Anti-nuclear antibodies are the most characteristic feature of> SLE
Oxidizing agents that are effective in treating cyanide poisoning due to their ability to> Induce methemoglobinemia.
Created by: Laymar
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