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DIT 2009 WK 9

Q&A from DIT emailed questions WK 9

How can a surgical lesion of the subthalamic nucleus might help improve the symptoms of Parkinson’s? Inhibitory pathway: Substantia nigra pars compacta’s dopamine binds to D2 receptors in the inhibitory pathway, inhibiting the inhibitory pathway (increasing motion)
MOA propylthiouracil? Inhibits organification and coupling of thyroid hormone synthesis, also decreases peripheral conversion of T4 to T3
Side effects of propylthiouracil? Skin rash, agranulocytosis (rare), and aplastic anemia
Phase of hepatic metabolism lost first by geriatric pts? Phase I
Phase of hepatic metabolism mediated by cytochrome p450 Phase I
Reactions involved in Phase I hepatic metabolism? HOR - Hydrolysis, Oxidation, Reduction
Substance that inhibits the conversion of dopamine to norepinephrine? Reserpine
Substance that inhibits the reuptake of choline by a presynaptic cholinergic neuron? Hemicholinium
What is an illusion? misinterpretations of actual external stimuli
What is a delusion? false beliefs not shared w/ other members of culture/subculture that are firmly maintained in spite of obvious proof of the contrary
What is a hallucination? perceptions in the absence of external stimuli
Enzyme deficient in alkaptonuria? Homogentistic acid oxidase
Manifestations of alkaptonuria? Dark connective tissue, pigmented sclera, urine turns black on standing “Long history of pain and stiffness”
What enzyme catalyzes the rate-limiting step in cholesterol synthesis? HMG-CoA reductase
What class of drugs inhibits this enzyme? Statins (Lovastatin)
Toxic side effects of phenytoin? Nystagmus, ataxia, diplopia, sedation, SLE-like syndrome, induction of cP-450. Chronic use produces gingival hyperplasia in children, peripheral neuropathy, hirsutism, megaloblastic anemia (dec folate absorption). Teratogenic (fetal hydantoin syndrome)
Valve most commonly involved in bacterial endocarditis? Mitral valve
Valve most commonly involved in acute rheumatic fever? Mital valve
On which cells would you expect to find MHC I? On almost all nucleated cells
On which cells would you expect to find MHC II? Only on antigen-presenting cells
How can neurotoxicity be prevented in pts receiving isoniazid (INH)? Give Vit B6 (Pyridoxine)
What are the signs of portal hypertension? Esophageal varices, melena, splenomegaly, caput medusa, ascites, hemorrhoids
What are the signs of liver failure? coma, sclera icterus, fetor hepaticus (corpse breath), spider nevi, gynecomastia, jaundice, testicular atrophy, liver “flap” (asterixis), bleeding tendency, anemia, ankle edema, decreased lipids & platelets
What is type I (alpha) error? A false positive error, will show that something “is” when it really “isn’t”
Give the neurotransmitter levels in Schizophrenia Inc dopamine
Give the neurotransmitter levels in Parkinson's Dec dopamine, Inc ACh
Give the neurotransmitter levels in Alzheimer's Dec ACh
Give the neurotransmitter levels in Hungtington's Dec GABA, Dec ACh
Give the neurotransmitter levels in Anxiety Inc NE, Dec GABA, Dec serotonin (5-HT)
Give the neurotransmitter levels in Depression Dec NE, Dec Serotonin (5-HT), Dec dopamine
Actions of angiotensin II? On vascular SM for Inc BP, Constricts efferent a., stimulates aldosterone release, Na/K pump in principal cells for h2O reabsorption, Stimulates ADH release from post pituitary, inc proximal tubule Na/H activity, stimulates thirst from hypothalamus
What is variable expression? Phenotypic severity varies b/w patients with the same mutation
What is incomplete penetrance? Not everyone w/ a mutant genotype will show the mutant phenotype (skips generations)
What is pleiotropy? Single genetic defect resulting in multiple phenotypic effects
What is anticipation? Severity of disease worsens or the age of onset is earlier in succeeding generations (assc. w/ trinucleotide repeats)
Which protozoa are responsible for Chaga's disease? Tryanosoma cruzi (Reduviid bug, Dx: blood smear, Rx: Nifurtimox)
Which protozoa are responsible for amoebic dysentery? Entamoeba histolytica (bloody diarrhea, liver abscess, dx: serology and/or Trophozoites or cysts in stool; Trophozoites with phagocytosed RBC’s, rx: Metro and iodoquinol)
Which protozoa are responsible for protozoal vaginitis? Trichonomas v. (foul-smelling, yellow-greenish discharge, alkaline, strawberry cervix, Dx: Trophozoites motile on wet mount, treat sexual partner as well)
Which protozoa are responsible for malaria? Plasmodium (Cyclic fever, headache, anemia, splenomegaly, Anopheles)
Which protozoa are responsible for spiking fevers, hepatosplenomegaly, pnacytopenia? Leishmania donovani (painful boils, Sandfly, Dx Macrophages with amastigotes, Rx Sodium stibogluconate & Ampho B)
Which protozoa are responsible for bloating, flatulence, foul-smelling diarrhea in campers and hikers? Giardia
What structures can be found in the cavernous sinus? CN III, IV, V1, V2, & VI and postganglionic sympathetic fivers en route to the orbit
What teratogen causes cervical clear cell adenocarcinoma? Diethylstilbestrol
Which teratogen (previously administered for morning sickness) causes limb defects? Thilidomide
Structures that form Hesselbach’s triangle? Inferior epigastric artery, Lateral border of rectus abdominis, & Inguinal ligament
Type of hernia that protrudes through Hesselbach’s triangle? Direct inguinal hernia
Most common tumor of the urinary tract? Transitional cell carcinoma
What is the usual presenting complaint of a pt with transitional cell carcinoma? Painless hematuria is suggestive of bladder cancer, can occur in renal calyses, renal pelvis, ureters, and bladder
What substance exposures increase the risk of developing transitional cell carcinoma? Phenacetin, Smoking, Aniline dyes, and Cyclophosphamide (Rx w/ Mesna)
Created by: snezya24



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