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DIT 2009 WK 3

Q&A from DIT emailed questions WK 3

QuestionAnswer
Rate-limiting enzymes for glycogen synthesis (Gluconeogenesis) Fructose 1-6 Bisphosphatase
Rate-limiting enzymes glycogen breakdown (Glycolysis) PFK-1
Rate-limiting enzymes fatty acid synthesis Acetyl-CoA carboxylase (ACC)
Rate-limiting enzymes fatty acid oxidation Carnitine acyltransferase I
Adrenergic antagonists used to treat hypertension and urinary retention in pts with benign prostatic hyperplasia (BPH) Prazosin (alpha 1 selective)
Risk factors for colon cancer colorectal villous adenomas, chronic IBD (especially ulcerative colitis, inc with age), FAP, HNPCC, past medical or family history; screen patients >50 yrs of age with stool occult blood test and colonoscopy
What is prevalence? Tot amnt of cases in population at a given time/total pop at risk at a given time
What is incidence? New cases over a given time/tot pop risk at that time
Relationship between prevalence and incidence for chronic diseases Prevalence > Incidence
Relationship between prevalence and incidence for acute diseases Prevalence = Incidence
What physiology accounts for the automaticity of the AV and SA nodes? - Phase 4: slow diastolic depolarization – membrane potential spontaneously depolarizes as Na conductance increase, accounts for automaticity of SA and AV nodes. The slope of phase 4 in the SA node determins HR
How does the emphysema caused by smoking differ from the emphysema caused by alpa-1-antitrypsin deficiency? Smoking emphysema is known as centriacinar, whereas alpha-1-antitrypsin def will result in panacinar emphysema (accompanied by liver cirrhosis)
What is the difference between Meissner’s corpuscle and a Pacinian corpuscle? *Meissner’s: found on glabrous (hairless) skin; sense dynamic fine touch, adapt quickly *Pacinian: found in deep skin layers, ligaments, and joints; sense vibration & pressure
What syndrome causes the triad of sterility, bronchiectasis, and recurrent sinusitis? Kartagener's Sx
What is the primary defect in Kartagener's syndrome? Dynein arm defect causing in immotile cilia, resulting in infertility do to immotile sperm, bronchiectasis
In which glomerular disease would you expect to see foot process effacement (electron microscope)? Minimal Change
In which glomerular disease would you expect to see wire-loop appearance (light microscope) Diabetic GN, Diffuse proliferative GN (due to SLE)
In which glomerular disease would you expect to see mesangial deposits of IgA (electron microscope) IgA Glomerulopathy (Berger's Dz)
In which glomerular disease would you expect to see crescent-moon shaped lesion (light microscope) Rapidly progressive (crescentic) GN
In which glomerular disease would you expect to sesegmental sclerosis and hyalinosis (light microscope) Focal Segmental Glomerulosclerosis
Clinical scenario most commonly seen in Reye’s syndrome Rare, often fatal childhood hepatoencephalopathy, microvesicular steatosis, hypoglycemia, coma
What are the characteristics of Reye's Sx? Associated with viral infection (especially VZV and Flu-B) that has been treated with salicylates
What would you expect to find in the synovial fluid of a pt with gout? Will have precipitation of monoscodium urate crystal (not uric acid!!) due to hyperuricemia. Crystals are needle shaped and negatively birefringent. MC in men
What would you expect to find in the synovial fluid of a pt with pseudogout? caused by deposition of calcium pyrophosphate crystals. Crystals are basophilic, rhomboid shaped and weakly positively birefringent, more common in large joints (like knee). No sex prevalence
What effects do prostaglandins have on platelet aggregation? Prostacyclin decreases platelet aggregation and promotes vasodilation (- Prostaglandins promote pain, uterine tone, T, and gastric mucosa decreasing vascular tone)
What effects does thromboxane have on platelet aggregation? Thromboxane (TXA2) promotes platelet aggregation and vasoconstriction
When is a fetus most susceptible to damage from teratogens? 3rd – 8th week of pregnancy
What drug used in the treatment of hypertension is a teratogen? ACE inhibitors - renal damage
Give the mechanism and time frame for hyperacute transplant rejection? Mech: preformed antidonor ab's in transplant recipient Time: minutes
Give the mechanism and time frame for acute transplant rejection? Mech: cell mediated - cytotoxic T lymphocytes Time: weeks (reversible)
Give the mechanism and time frame for chronic transplant rejection? Mech: Tcell & ab-mediated vascular damage Time: Mo's to Yrs (irreversible)
What is Zollinger-Ellison syndrome? - Gastrin-secreting tumor of pancreas or duodenum, recurrent ulcers, associated w/ MEN 1. RX: Octreotide
What type of collagen is abnormal in patients with Alport’s syndrome? Type IV Collagen
Order elimination with rate of elimination proportional to the drug concentration? 1st Order
What is the most common tumor of the adrenal medulla in adults? Pheochromocytoma
What is the most common tumor of the adrenal medulla in children? Neuroblastoma
What lab abnormalities would you expect to see in a pt with SIADH? - Too much ADH will cause excessive water retention, hyponatremia (retaining salt, can lead to seizures), urine osmolarity > serum osmolarity (concentrating urine)
What drugs are used in the treatment of Parkinson’s disease? - BALSA: Bromocriptine (pramipexole, ropinorole), Amantidine (SE: ataxia), L-dopa/carbidopa (B6 decrease effectiveness), Selegiline (Tolcapone), Anti-Muscarinic (Benztropine)
Created by: snezya24