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How do you treat CN poisoning? Amyl Nitrite (produces metHb which binds to CN) and Thiosulfate (CN to thiocyante)
What is Bosentan used to treat? How does it work? Tx Pulmonary Hypertension; competitively antagonizes endothelin-1 receptors and decreases pulmonary vascular resistance
What is the most common type of lung CA in women/nonsmokers? Adenocarcinoma: peripheral, develops at site of prior pulmonary injury
What is the pathophysiology of ARDS? Diffuse alveolar damage, incr capillary permeability, protein-rich fluid leakage into alveoli, hyaline membrane formation
Which type of penumoconioses has incr susceptibility to TB, why? Silicosis; the silica impairs macrophages
In RBCs, what maintains electrical neutrality as CO2 is transported in RBC as HCO3? HCO3/Cl exchanger in red cell membrane
What is the formula for alveolar gas equation? PAO2 = PIO2 - PACO2/0.8
What causes primary pulmonary hypertension? inactivating mutation in the BMPR2 (would normally inhibit vascular smooth muscle proliferation)
What is the typical tidal volume? 500 mL
Where is the pulmonary artery situated in relation to the bronchus in the right lung? left lung? RIGHT - artery ANTERIOR to bronchus; LEFT - artery SUPERIOR to bronchus
Which is last to disappear as you descend down the respiratory tract, cilia or goblet cells? Cilia. (extend to respiratory bronchioles) while goblet cells extend only to terminal bronchioles
Which type of breast CA has the worst prognosis? Invasive ductal; most common; tumor cells in cords, glands embedded in dense fibrous stroma (rock hard mass)
Define Meig's syndrome. Triad of ovarian fibroma, ascites, and hydrothorax
Define Call-Exner bodies. Small follicles filled with eosinophilic secretions; associated with Granulosa cell tumor
What are the hormone derangements in PCOS? Increased LH, Decreased FSH, Increased Testosterone
Which type of hydatidiform mole contains some fetal parts? What is the typical karyotype? Partial mole, 69 XXY (2 sperm + 1 egg)
Which type of hydatidiform mole can convert to choriocarcinoma? What is the typical karyotype? Complete mole, 46 XX (2 sperm)
What are the hormonal derangements in Klinefelter's syndrome? Decr inhibin, Incr FSH; Decr testosterone, Incr LH, Incr Estrogen
What are some of the prostate products of semen? Zinc, citric acid, phospholipids, acid phosphatase, fibrinolysin (make up 20%)
What are some of the seminal vesicle products of semen? Fructose, ascorbic acid, prostaglandins, phosphorylcholine, flavins (make up 60%)
What structures are contained within the broad ligament? ovaries, fallopian tubes, and round ligament of the uterus
What is contained within the cardinal ligament, where does it attach? Contains uterine vessels, attaches cervix to side wall of pelvis
What contributes to elastin's ability to recoil? extracellular interchain crosslinks involving lysine
How are different sized particles removed from the lung? Small, < 2 microns: phagocytossis Larger, 2.5-10 microns: mucociliary transport
How is Diptheria treated? Diptheria antitoxin (passive immunity), penicillin, DPT vaccine (active immunity)
What is the most common cause of a continuous murmur in children? cervical venous hum
Impaired filling of the R side of the heart will affect which portion of the JVP? a wave will be exaggerated (atrial contraction)
What accumulates in the cusps of the mitral valve in MVP? dermatan sulfate (myxomatous degeneration)
What is the cause of sudden death in a patient with hypertrophic cardiomyopathy? v tach or v fib
What is the most common cause of sideroblastic anemia? Why? chronic alcoholism, alcohol is mitochondrial toxin (1st and last steps of heme synthesis take place in the mitochondria)
Why does phenytoin cause folate deficiency? inhibits intestinal conjugase (folate needs to be in monoglutamate form to be absorbed)
What is the most common cause of elevated homocysteine level (in the US)? folate deficiency
What chromosomal mutation is associated with Polycythemia Vera and other MPDs? JAK2 on chromosome 9
Define smudge cells. In what disorder are they prominent? fragile leukemic cells; CLL
Which of the leukemias is the only type with out lymphadenopathy? Hairy cell leukemia, TRAP (+)
HPV causes laryngeal cancer on which vocal cords? stat squam on TRUE vocal cords
At FRC of the lungs, is the intrapleural pressure positive or negative? It is slightly (-) with a value of -5 mmHg (PVR is also lowest at this point)
Define Reed Sternberg cell characteristic cell of HL; has two mirror image nuclei each with eosinophlic nucleolus surrounded by clear halo; CD 15 and CD 30 (+)
Which type of HL is most associated with EBV? Mixed cellularity
Which type of HL has the poorest prognosis? Lymphocyte depleted with frequent RS cells
What is the characteristic cell of Histiocytosis X? Langerhans cell, CD 1 (+) with Birebeck granules in the shape of tennis rackets on EM
What causes lytic bone lesions in a MM pt? myeloma cells (-) osteoblastic differentation and release IL-1 which activates osteoclasts
What is the most common cause of hypersplenism resulting in pancytopenia? portal HTN associated w/ cirrhosis
In a pt with splenic dysfunction, loss of what protein leads increased susceptibility to infection with encapsulated organisms? tuftsin(activates receptors on macs to increase phagocytic activity)
Which coagulation factors are consumed in the formation of a fibrin clot? Fibrinogen, Prothrombin, V, VIII
What three diseases is vWF deficiency associated with? Mitral valve prolapse, Marfan's, Angiodysplasia
Which Ab can cause hemolytic anemia in M. pneumoniae infection? anti-I
Which Ab can cause hemolytic anemia in Mononucleosis infection? anti-i
How much should one unit of pRBCs raise H&H? 1 g/dl and 3%
What is the most contaminant of stored blood? Yersinia entercolitica (loves Fe)
How do you tx DIC? What does it contain? cryoprecipitate: factor 8, 13, fibrinogen
What is the most common bacterial cause of acute COPD exacerbation? H. flu
What is the most likely cause of death in Acute Rheumatic Fever? Heart failure due to severe myocarditis
What enzyme deficiency presents with maternal virilization during pregnancy and masculinization of the female fetus? aromatase
What is the formula for RBF? RBF = PAH Cl / 1 - Hct
In restrictive lung diseases, why is FEV1/FVC slightly increased? loss of radial traction exerted on conducting airways by the fibrotic lung
What is Cilostazol used to tx and what is its MOA? used to tx intermittent claudication in PVD; PDE (-) inhibits plt aggregation and is an arterial vasodilator
What is the significance of cord factor in mycobacteria? 2 mycolic acid moleucles bound to disaccharide terhalose, correlates with virulence
What is the most potent cerebral vasodilator? pCO2 which leads to increased ICP
What is mucicarmine stain red? polysaccharide capsule of Cryptococcus neoformans?
What is caplan syndrome? Rheumatoid nodules in lungs + pneumoconiosis
What is the pathogenesis of achalasia? loss of NO synthase producing neurons leads to incomplete relaxation
What drug is used to tx pain associated with cholecystitis? Meperidine (do not use morphin, it contracts sphincter of Oddi)
What is the pathogenesis of appendicitis in children? lymphoid hyperplasia secondary to viral infection
What is Turcot's polyposis? AR polyposis syndrome of the colon also associated with astrocytoma and medulloblastoma
What is Gardner's syndrome? AD polyposis syndrome associated with benign osteomas and desmoid tumors
What is Angiodysplasia? dilation of mucosal and submucosal venules in cecum and right colon leading to hematochezia; associated with vWD and aortic stenosis
What is the classic histologic finding in Psoriasis? Munro abscesses - neutrophilic collections in the stratum corneum
What happens to the T cell profile in Sarcoidosis? increased CD4:CD8 ratio
Define Familial Dysbetalipoproteinemia. defects in ApoE3 and ApoE4 which are responsible for VLDL and chylomicron reuptake by liver cells
Which lipoprotein assembles chylomicrons for secretion by the intestine? ApoB48
Which lipoprotein activates lipoprotein lipase? ApoCII
Which lipoprotein aids in cholesterol esterification? ApoA-1
Which lipoprotein aids in LDL particle uptake by non-hepatic cells? ApoB100
What is the formula for Plasma osmolarity? What is the nl range? POsm = 2 (Na) + glucose/18 + BUN/2.8; nl 275-295 mOsm/kg
How does heart failure cause dyspnea (specific receptors)? interstitial fluid accumulates and stimulates juxtacapillary J receptors innervated by vagus nerve
Why is sudden cardiac death associated w/ an MI most common in the morning hours? hypercoaguability is at its peak
How is hydroxyurea used as a preventative measure for sickle cell crisis? increases fraction of fetal hemoglobin
How does pyruvate kinase deficiency cause hemolysis? no PEP --> pyruvate; lack of ATP causes membrane damage and dehydrated RBCs
Created by: ash0403



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