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DIT 2009 WK 7

Q&A from DIT emailed questions WK 7

MOA of Nicotinic ACh receptors Ligand-gated Na/K channels
MOA of Muscarinic ACh receptors G-protein-coupled receptors that act through 2nd messengers
Structures injured in an unhappy triad knee injury Medial collateral Ligament, Anterior Cruciate Ligament, Medial Meniscus
Fungal infection responsible for diaper rash? Candida albicans (germ tube formation at 37 C is dx, satellite lesions)
Fungal infection known to be an opportunistic mold with irregular nonspetate hyphae that branch at wide angles (>90 degrees) Mucor & Rhizopus
Fungal infection known to be dimorphic fungi and is common to SW US (aka San Joaquin Valley fever) Coccidioidomycosis (spherule filled with endospores at body temp)
Fungal infection that • causes thrush in immunocompromised pts and vulvovaginitis in women Candida albicans
Fungal infection described as dimorphic fungi with broad-based budding yeast Blastomycosis (50% infected are asymptomatic)
Fungal infection known for causing pneumonia in AIDS pts -> start Bactrim prophylaxis when CD4 <200 PCP (small, disk-shaped organisms, ground glass)
Dimorphic fungi common to Mississippi and Ohio river valleys Histoplasmosis (bird&bats, Macrophage filled with Histoplasma, can proliferate in macrophage, 90% pts asymptomatic)
Fungal infection that causes skin infection in those pricked by a thorn Sporothrix schenckii (cigar-shaped, unequal budding)
Yeast known for causing meningitis in AIDS pts Cryptococcus neoformans (soap bubble, India ink)
Opportunistic mold with septate hyphae that branch at a 45 degree angle Aspergillus fumigates (broom-like structure on silver stain)
Why do kidneys retain fluid in heart failure pts? Dec LV contractility leads to Dec CO which can lead to either Inc Renin-Angio-Aldo thus increasing Renal Na&H2O reabsorption OR by Inc of Sympathetic action and also In Na H2O reabs
What is the antidote for t-PA or streptokinase overdose? t-PA/streptokinase OD – aminocaproic acid
What is ankylosing spondylitis? Chronic inflammatory disease of spine and sacroiliac joints -> ankylosis (stiff spine due to fusion of joints), uveitis, and Ao regurgitation
What is the typical profile of a pt with ankylosing spondylitis? Young male with morning stiffness (ankylosis), uveitis, and Ao regurgitation
Where would you expect to find type I collagen? (90% of all collagen, 30% of body weight) – Bone, Skin, Tendons, dentin, Fascia, cornea, late wound repair
Where would you expect to find type II collagen? Cartilage (including hyaline), vitreous body, nucleus pulposus
Describe how bromocriptine inhibits prolactin secretion • Increased dopamine synthesis and secretion production from hypothalamus subsequently inhibits prolactin secretion. Bromocriptine is a dopamine agonist that will increase dopamine and thus inhibit prolactin
How do NSAIDS cause renal damage? Can cause acute renal failure by inhibiting the renal production of prostaglandins, which keep the afferent arterioles vasodilated to maintain GFR
What is the underlying problem in Gilbert’s syndrome? Mildly decreased UDP-glucuronyl transferase or dec bilirubin uptake. Inc unconjugated bilirubin w/o overt hemolysis
What is the underlying problem in Crigler-Najjar syndrome (type I)? Absent UDP-glucuronyl transferase, presents early in life. Inc unconjugated bilirubin, kernicterus
What is the underlying problem in Dubin-Johnson syndrome? defective liver excretion. Inc conjugated bilirubin. Benign, grossly black liver
What is Lambert-Eaton syndrome? Muscle weakness (like MS) due to antibodies against presynaptic Ca channels at neuromuscular junction
Which neoplasms can cause Eaton-Lambert syndrome? Thymoma and Small cell lung Carcinoma
Where are T cells found in the spleen? Periarterial lymphatic sheath (PALS) and in the red pulp of the spleen
Where are B cells found in the spleen? Follicles within the white pulp of the spleen
What gives rise to the jugular venous a wave? Atrial contraction
What gives rise to the jugular venous c wave? RV contraction (tricuspid valve bulging in to atrium – systole)
What gives rise to the jugular venous v wave? Inc. atrial pressure due to filling against closed tricuspid valve (max atrial filling)
What are the beta-1-selective beta-blockers? Acebutolol (partial agonist), Betaxolol, Esmolol (short acting), Atenolol, Metoprolol
What embryologic buds give rise to the pancreas? Forgut - ventral and dorsal pancreatic buds
What pancreatic structures does the ventral pancreatic bud give rise to? pancreatic head, uncinate process (lower half of head), and main pancreatic bud
What pancreatic structures does the dorsal pancreatic bud give rise to? body, tail, isthmus, and accessory pancreatic duct (all else)
What enzymes do obligate anaerobes lack? Catalase and/or superoxide dismutase making them susceptible to oxidative damage
In which pt populations is Aztreonam a good choice? Penicillin allergies
Against which organisms is this antibiotic effective? Enterobacter
By what mechanism is digoxin a positive inotrope? by decreasing EC Na, decreasing activity of Na/Ca exchanger
What are some of the signs and symptoms of Parkinson’s disease? Tremor (at rest), cogwheel Rigidity, and Postural instability
Steps involved in the pupillary light reflex. Light in either retina sends signal via CN II to pretectal nuclei in midbrain that activate bilateral Edinger-Westphal nuclei; pupils contract bilaterally (consensual reflex)
Created by: snezya24