IL-5 - who releases it? - what does it do?

- Th2 cells - Promotes differentiation of B cells. - Enhances class switching to IgA. - Stimulates growth/differentiation of eosinophils.

- glans penis, corpus cavernosum/spongiosum (via DHT) - glans clitorus, vestibular bulbs (via E)

- ventral shaft of penis (urethra) - labia minora

Superficial inguinal nodes - location - what do they drain

- anterior thigh, right under inguinal ligament. - drain nearly all cutaneous structures inferior to umbilicus including the external genitalia and the anus up to the pectinate line. Includes scrotum.

- D2 agonist - used in parkinsons.

- necrolytic migratory erythema. - hyperglycemia/DM - GI Sxs - normochromic normocytic anemia

- delayed wound healing - hypogonadism - alopecia - dysgeusia, anosmia - acrodermatitis enteropathica - may predispose to alcoholic cirrhosis.

2/20 Flashcards by Mike Mah

IL-5

who releases it?
what does it do?

Th2 cells
Promotes differentiation of B cells.
Enhances class switching to IgA.
Stimulates growth/differentiation of eosinophils.

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IL-3

Supports growth/differentiation of bone marrow stem cells.

-functions like GM-CSF

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Genital tubercle

glans penis, corpus cavernosum/spongiosum (via DHT)

- glans clitorus, vestibular bulbs (via E)

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Urogenital folds

ventral shaft of penis (urethra)

- labia minora

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Lacioscrotal swelling

scrotum

- labia majora

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Hypocalcemia/parasthesias after a blood transfusion? How?

Citrate is an anti-coagulant thats mixed into blood transfusions prior to storage.

Citrate can chelate calcium and cause hypocalcemia.
usually after a massive transfusion.

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Hyperkalemia after a blood transfusion? How?

RBCs may lyse in old blood units.

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Partial central DI vs Complete central DI

> 50% inc. in urine osm = complete
<50% inc. in urine osm = partial

-measured 1 hr after DDAVP infusion.

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Superficial inguinal nodes

location
what do they drain

anterior thigh, right under inguinal ligament.
drain nearly all cutaneous structures inferior to umbilicus including the external genitalia and the anus up to the pectinate line. Includes scrotum.

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Deep inguinal nodes

location
what do they drain

under fascia lata, on medial side of femoral vein.

- superficial inguinal nodes, deep lymphatic trunks along the femoral vessels, glans penis & clitoris.

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Pergolide

D2 agonist

- used in parkinsons.

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Sulfonylureas

-mechanism

-close potassium channel in beta-cell => depolarizes cell

=> Ca influx => insulin release.

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Glyburide, glipizine, glimepiride.

-sulfonylurea, 2nd gen.

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Axial images (even CT scans)

viewed from patients feet.

- so left side of image is pt’s right side.

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Most common finding in PCA infarct?

-which CNs does PCA help supply?

contralateral hemianopia often w/macular sparing.

- CN 3 & 4

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Ischemic stroke affects which vessel the most often?

MCA

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Glucagonoma

necrolytic migratory erythema.
hyperglycemia/DM
GI Sxs
normochromic normocytic anemia

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Zinc deficiency

delayed wound healing
hypogonadism
alopecia
dysgeusia, anosmia
acrodermatitis enteropathica
may predispose to alcoholic cirrhosis.

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inulin

Not resorbed & not secreted

~GFR

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PAH

Filtered & actively secreted
~RPF
*not resorbed

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creatinine

-Not resorbed & slightly secreted
-Kind of like inulin
~GFR
*overestimates GFR a tad b/c its slightly secreted.

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Resorption of filtered water in the tubule

60% PCT
20% descending henle
up to 20% collecting duct (via ADH) depending on hydration status.

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Fructose intolerance

-do you get cataracts?

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Urine distick

-detects which sugars?

Only glucose

-no fructose or galactose.

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Interviewing technique: reflection

Physician repeats what the patient tells him.

Neurogenic bladder vs urinary retention

- Neurogenic bladder - you cant control your pee, so you give them a muscarinic antagonist so they dont pee themselves. - Urinary retention following surgery - they cant pee, so you give them a muscarinic agonist so they can pee.

Oxybutynin

anti-muscarinic | -for urge incontinence.

Regression of notochord & thyroglossal duct | -what is this an example of?

atrophy

TCA | -block what receptors

- anti-alpha1 | - anti-cholinergic

Anti-psychotics | -block what receptors

- anti-alpha1 - anti-muscarinic - anti-histamine

tamsulosin

- alpha-1 blocker but specific for prostate. | - doesn't affect vasculature.

TCAs = watch out when giving a pt w/BPH

-could further inc. their urinary retention.

SVC block vs brachiocephalic block

-SVC block would affect both sides whereas brachiocephalic affects 1.

Normal pCO2 levels? | Normal serum bicarb?

- 33-35 mmHg | - 22-28 mEq/L

Aspirin poisoning | -order of events

1) acute respiratory alkalosis b/c aspirin stimulates respiratory center to hyperventilate. 2) few hours later, metabolic acidosis. * low bicarb due to metabolic acidosis, not renal comp for resp alkalosis. (renal comp takes at least a few days to kick in).

Where is juxtaglomerular apparatus? | Where is macula densa?

- afferent arteriole | - DCT

HIDA scan

-no radionuclide taken into gallbladder = blockage of cystic duct.

S-100 | -marker for what?

- neural crest origin. | - melanoma, schwannoma, langerhan cell histiocytosis, neural tumors.

Which cranial nerve can schwannomas NOT arise from?

CN2 (covered by oligodendros).

karyorrhexis

nuclear fragmentation

Apop: DNA laddering | -how big are fragments?

180-bp fragments

How does radiation therapy kill cells?

Induces apoptosis via free radicals & ds breaks.

BAX, BAF, bcl-2 | -anti or pro apoptosis?

BAX & BAF = pro-apop Bcl-2 = anti-apop (by inhibiting APAF) *over-expression of bcl-2 = cancer

Fas-FasL interaction. Where do we see this? | -what happens when there are mutation in FAS?

- thymic medullary negative selection. | - Mutations in Fas increases numbers of circulating self-reacting lymphocytes due to failure of clonal deletion.

Whats the first sign of shock?

tachy

Distributive shock includes: | *distributive = high output

- septic - neurogenic - anaphylactic

PCWP (LA pressure) only inc. in which type of shock?

-cardiogenic shock. b/c of fluid backup.

Fibrinous inflammation

-acute infl: fibrinogen leaks out of permeable vessels and polymerizes to fibrin on surface of organ.

CD 14 on macros

TLR

Psammoma bodies | -dystrophic or metastatic calcification?

-dystrophic.

Metastatic calcification: - in which tissues most often? - why?

- Gastric, renal, lungs - these tissues lose acid quickly. Alkaline environment favors deposition of calcium. * ALP released by osteoblasts makes alkaline environment and then lays down bone.

Margination/Rolling

- endo: selectins/GlyCAM-1, CD34 | - WBC: Sialyl-LewisX, L-selectin

Adhesion

- endo: CAMs (cell adhesion molecules) | - WBC: CD11/18 integrins (LFA-1, Mac-1), VLA-4 integrin

Diapedesis

- endo: PECAM-1 (CD-31) | - WBC: PECAM-1 (CD-31)

oxidative bust

first step w/NADPH oxidase. | -superoxide turns NBT blue

fibroblast growth factor | -whats it do?

angiogenesis

EGF | -how do these stimulate growth?

-tyrosine kinase activation

Decreased ESR found in:

Sickle cell, polycythemia, CHF.

Iron poisoning

-can lead to metabolic acidosis.

Primary amyloidosis

AL: Ig light chain | -plasma cell disorder/multiple myeloma

Secondary amyloidosis

AA: amyloid A

Dialysis amyloidosis - build up of what? - may present as what?

beta-2-microglobulin | -may present as carpal tunnel

G6PD A:B ratio - hyperplasia - neoplasia

- normal: 1:1 - hyperplasia: 1:1 - neoplasia: either A or B will be huge compared to the other. monoclonal prolif.

Barr Body

-Female: each cell in body inactivates an X chromosome (either one from mom or dad) randomly. So by chance alone it'll be 1:1 ratio.

vimentin | -stains for which cancer

sarcomas | -vimentin = connective tissue IF.

dermatomyositis associated w/which cancer?

lung cancer

keratin | -marker for what

epithelial cells

``` Liver fluke (Clonorchis sinensis) -which cancer? ```

Cholangiocarcinoma

Schistosoma haematobium | -which cancer?

Bladder cancer (squamous cell)

Aflatoxins cause mutations in what?

p53 genes

which cancer has highest mortality rate among both men and women?

lung cancer

Neonatal HIV - Sxs? - prevention?

- oral thrush, severe lymphopenia, interstitial pneumonia. | - give mother zidovudine during pregnancy starting at 14 wks then to baby for six weeks post-partum.

Common cardinal veins | -whats derived from these?

-right common cardinal v. + right anterior cardinal v. = SVC.

What does truncus arteriosus give rise to?

asc. aorta & pulm. trunk

What are 3 groups that fetus' veins fall into?

Vitelline, umbilical, Cardinal

Fate of vitelline veins?

form veins of portal system

Fate of umbilical veins?

degenerate

Fate of cardinal veins?

form veins of systemic circ.

What is the biggest factor in determinging coronary blood flow? Esp. during exercise.

Duration of diastole.

Capitation

- physicians paid a fixed amount per pt. not per service. - so there is incentive to contain costs due to fixed budget allocated to them. - strongly associated w/preventative care.

What are 2 primary contributors to serum ALP?

liver (including biliary system) and bone.

How do you test for cystinuria? | -how do u treat it?

Sodium nitroprusside test is positive. Detects urine cystine. Detects cystine's sulfhydryl groups. -treat: hydration & alkalinization of urine.

Sites on Ig for attachment

-complement attaches above where macros/neutros/b cells bind via Fc receptors.

Where is aortic regurg heard?

- left sternal border. | - 2/3rd rib space.

Papillary muscle defect results in what cardiac murmur?

-mitral valve regurg.

Osteomyelitis: most common location - kids - adults

- kids = metaphysis | - adults = epiphysis or vertebral body

sequestrum

dead piece of bone

Use of GGT (gamma glutamyl transpeptidase)?

distinguishing btwn bone or biliary system as the source of the elevated ALP. - NOT found in bone disease. - found primarily in hepatocytes and biliary epithelia.

Lacrimation, salivation, flushing (vasodilation), diaphoresis, miosis. -too much what NT?

muscarinic cholinergic overstimulation. | -too much ACh.

2/20 Flashcards

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