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JK-USMLE Stk-2

QuestionAnswer
Potter syndrome Persistent oligohydramnios. Clubfeet, clasic faces, nasal, ocular ear, and jaw deformities, and pulmonary hypoplasia. Bilateral renal aplasa
Homophilia A,B,C are deficiency of Factor 8,9,11 deficiency, respectively
Immunoglobulin gene switching order IgM, D, G,E, A. hyper-IgM syndrome most commonly results in lymphoid hyperplasia. Most commolny from absence of CD-40 ligands on T-lymphocyte.
Characteristics of IgA Secretory immunoglobulin, monomer or dimerof two IgAs, joine by J chain. Present in colostrum,. IgA class switch by stimulation of TGF-beta. Selective IgA deficiency, most common B-cell related immunodeficiency
Characteristics of IgE Responsible for asthma, atopic dermatitis, allergic rhinitis defense against helminth parasites. Isotype switch by IL-4. Binds on to Fc receptors of mast cells and basophils at Fc regions. Two IgE signals granular content release --> Allergic rxn.
Characteristics of IgG Cross placenta, Most effective immunoglobulin opsonic, immunity against bacterial toxins.
Hyperacute Occurs immediately, resultant is ischemia. AKA white graft
Acute rejection occurs 1-2 weeks after receiving a transplant CD8 T cells plays a central role. Acute rejection causes vascular damage. Manifests with dyspnea, dry cough, low grade fever. Shows lowe robe opacities.
Chronic rejection Months to years. Major cause of mortality in lung transplantation. Causes inflammation of sm. Bronchioles. Ie. Bronchiolitis obliterans. Symptoms include dyspnea and wheezing.
Pancreatic insufficiency associated with cystic fibrosis
Negative selection of T cells occur at where and what does Thymic medullary and epithelial and dendritic cells
Postive selection of T cells occur at where and what does Thymic cortical epithelial cells expresing MHC
Heteroplasmy of mitochondrial disease Variability in severity of the disease. Mitochondrial syndromes 1) Leber hereditary optic neuropathy--> Bilateral vison loss. 2)Myoclonic epilepsy with ragged-red fibers: 3) Mitochondrial encephalomyopathywith lactic acidosis and stroke like episodes (MEL
Low to Moderate dose of Methylxanthine Mild cortical and arousal and insomnia, like caffeine
Acute theophylline intoxication and Tx Abdominal pain, vomiting, diarrhea, cardiac arrhythmia, and seizure. Tx. Gastric lavage, activated charchol, cathartics, beta-blocker for tachyarrhythmia
Superior venacava Syndrome Compression of SVP, easily compressed by mediastinal mass. Bronchogenic cacinoma most common cause of SVP syndrome. Non-Hodgekin lymphoma second most common. Presents with dyspnea, cough, swelling of the face neck and upper extremities.
Pericardial effusion presentaiokn Dyspnea, distended neck veins, heart soundsm pulsus paradox (decrease in >10mm during inspiratiokn
Pleural effusion diagnosis Dullness to percussion and diminished breathsound on PE
Small cel carcinoma of lung Associated with Cusing due to ACTH secretion and SIADH
Squamous cell carcinoma secrete secrete PTH-related peptide, causeing hypercalcimia
Ocular nerve originates and goes through Oculomotor nucleus of the id brain, through Superior orbital fissue.
Sensory limb of corneal reflex mediated by Nsociliary branch of first banch of CNV1
Trochlear trochlear nerve and abducen nerve goes through Superior orbital fissue
Inferior orbital fissue Maxillary divison of the trigeminal nerve,
Optic canal, Transmt Optic nerve CNII
Foramen rotundum trasmits Maxillary division of trigenmnal nerver
Mandibular branch of CNV3 pass through Foramen Ovale
Superior orbital fissue contains CNIII Oculomotor, Optahlmic nerve CNV1, Trochlear nerve CNIV, Abducens nerve CN VI, and superior opthalmic vein enter orbit via superior orbital fissue.
Noremal Pressure of Rt atrium 0,8
Noremal Pressure of Rt ventricle 4, 25
Noremal Pressure of Pulmonary artery 9,25
Noremal Pressure of left atrium 2, 12
Noremal Pressure of left ventricle 9,130
Noremal Pressure of Aorta 70,130
Unilaterla vesicular rash localized on a single dermatomes persis more than a month Post-herpetic neuralgia, stabbing pain, most common neurological complication of varicella zoster virus
Sertoli cells does what and respose to what? Analogous to the female's what cell? Maintain spermatogenesis, release inhibin and Secrete mullerian Inhibiting factor (MIF). Inhibin negatively feedback on FSH secretion by the ant. Pituitary. Analogous to Granulosa Cells
Theca cells produce what and response to what? Produce testosterone and response to LH.
In general, Inhaled particles are cleared by what cels? Epithelial cilia (Present to the level of the termianl bronchioles) vai mucociliary clearance.
What's the function of Goblet cells Secretionof mucous onto mucosal epithelium.
What are clara cells non-ciliated secretory constituents of termianl resp. epithelium. Secrete clara cell secretory protein, component of surfactants. Involved in detoxification of inhaled toxins by cyt P450 mechanism.
Type 1 pneumocytes Mediates alveolar gas exchange
Type 2 pneumocytes Produce surfactants and divide and differentiate into type 1 peumocytes
Signs of Pneumonia Fever, leukocytosis, radiographic lung opacities
Elderly, Dementia, Hemiparesis, lung consolidation pneumonia
Extended immobility in supine position Atelectasis in the posterior lung
Afrian American, Female, X-ray, Hilar lymph node, elevated ACE Sarcoidosis. Causes arthralgia, skin lesion(erythema nodosum), plaques. Scattered granulomas affects the portal triads, Non-caseating granulomas
Hepatic centrilobar necrosis Deaht of hepatocytes surrounding termianl hepatic vein.
What's sucrose Fructose Glucose
What's lactose Galactose + Glucose
What's sucrose Glucose + Glucose
What's Aldolase B? Involve din metabolizing fructose 1 phosphate. Those that are deficiency of this enzyme should avoid fructose
Amylose vs amylospectin amylose: unbranched, Amylopectin: Branched
Bacterias that can survive past boiling pt of water Bacillus and Clostridum.
Cell typs of paranaal sinus Cilliated, Pseudostratified, colunar, mucus secreting epithelium
Cell typs of Laryngeal vestibule space at the top of the larynx bordered by lower half of the posterior epiglottis
Cell types of trachea Entirely lined by pseudostratified, columnar, mucus-secreting epithelium.
SE of ACE inhibitors Angioedema, of lips, larynx,
Class 1 arrythmic modulates? Sodium Channel
Class 2 arrythmic modulates? Sympathetic nervous system
Class 3 arrythmic modulates? Potassium channels
Class 4 arrythmic modulates? Calcium channel blockers
Digitalis toxicity? Conduction block
SE of Thioridazine Retinal deposit that resemble retinitits pigmentosa
SE of Chlorpromazine corneal deposits
SE of Haloperidol Extrapyramidal symptoms
SE of Ziprasidone Prolonged QT
SE of Olanzapine Weight Gain
SE of Clozapine Agranulocytosis and seizures
Warfarin Oral anticoagulant drug that is tightly bound to plasma protein after absorption by the gut. Metabolized in the liver via P450system, BP is ripping Carbama.
Nifedipine Dihydropyridine calcium channel blocker with min. effects on SA and Cardiac conduction. Acts as a vasodilator and can cause reflx increase HR.
Verapamil and Diltiazem Non-dihydropyridine-type calcium hannel blocker
In what pathway does antipsycotic drugs block dopamine Tuberoinfundibular Pathway. Associated with Hyperprolactinemia
Mesolimbic-mesocortical pathway is primary involved in Regulating Behavior. Hyperactive in schizophrenia
Nigrostrial system Subsancia nigra to the caudate nucleus and putamen. Coordinate voluntary movements. In this pathway, dopain inhibits acetylcholine. Degeneration of substantia nigra causes deceased dopamine and subsequent incease in acetylcholine---> Parkinsonism.
Neostigmine Acetylcholine esterase inhibitor
Succinylcholine Depolarizing NMJ bloker
Dantrolene relaxes skeletal msucle by reducing release of Ca++ from sarcoplasmic reticulum.
What are three drugs that prevents reduction of folic acid to tetrahydrofolate? Trimethoprim(With microbecide), methotrexate(rapidly dividing cells), pyrimethamine(inhibits paraitic DHF reductase)
Diphenoxylate Anti-Diarrheal, structurally similar to meperidine. Binds to mu receptors in the gastrointestinal tract and slows motility.
What helps in secretory diarrhea? Octreotide
Shigellosis is S. Sonnei, most common in the US. Shigella invades gastrointestinal mucosa via 1) gaining access to M cells in Peyer's patches in the ileum through endocytosos. 2)Then lyses th endosomes, spreads laterally into other epithelial cells, causes ell eath and
Goblet cells do what? Secretion into the gut lumen. Mucus release is increased in inflammatory state.
Paneth cells First line of defesne against intestinal microbes. Secrete lysozyme, enzyme capable of dissovling the cell wall of bacteria, defensins, polypeptides that have antimicrobial and antiparasitic properties.
Shiga-like toxin of E. Coli Toxicity of renal endothelialcells, leding renal insufficiency and uremia
Patient with CF produce sweat high in Sodium and chloride
Astrocytomas and medullomastomas arise in the Cerebelum. Medulloblastomas ar alled PNET primitive neuroectodermal tumors. Abundant mitosis. Cerebellar vermis most commons location of medulloblastoma. Signs: Increased intracranial pressure.
Pilocytic astrocytoma Most common brain neoplasm of childhood. Pilocytic astrocytes and Rosenthal fibers seen.
Ependymoma. 3rd most common brain neoplasm found in children.
Region most succeptable to ischemic injury in Kidney Very outter part of medulla. Part of proxmal tubule and ascendin loop of henle has very low blood supply and uses ATP. ATN produces flattening of epithelial cells.
Papillary necrosis is associated with Diabetes mellitus analgeisc, nephropathy, and scikle cell disease
SS+ RNA virus Rhino virus, pinornavirus. Where as SS- RNA virus are not
Influenza A, how does it replicate? Orthomyxovirus, replicate in host cell, an RNA dependent RNA polymerase within the intat viron must enter
Created by: jskim