What is the mechanism of death in pts with TCA overdose?
-inhibition of fast sodium channels in the heart —> arrhythmias
Phosphorylated Rb is ________, allowing cells to _______
- Inactive
- Proceed from G1—>S phase
What is the RL step for bile acid synthesis?
-Cholesterol-7-alpha hydroxylase
Pancreatic cysts most commonly form in the _______. THier walls are made of _______
- Lesser peritoneal sac
- Granulation tissue and fibrosis
Interstitial myocardial clumps of immune cells following infection = ______
-Bacterial myocarditis (ARF)
What is the treatment for acute Arsenic poisoning?
- Dimercaprol
* SE = nephrotox and HTN
What is seen histologically in an atrophied kidney?
- crowded glomeruli
- tubulointerstitial atrophy and fibrosis
- focal inflamm infiltrates
Describe the adenoma to carcinoma sequence of colon cancer:
- Normal mucose to small polyp —> due to APC mutation
- Growth of polyp –> mutation of K-ras (stimulation of cell cycle progression)
- Malignant transformation —> p53 and DCC mutations
Where is damage typically done in patients with autoimmune gastritis causing B12 deficiency?
-Body of the stomach
Name some drugs that cause hyperUricemia and may cause gouty attack?
- Niacin
- HCTZ
- cyclosporine
- pyrazinamide
Pathophys and presentation of Fabry dz?
Path:
- Alpha-galactosidase deficiency
- ceramide trihexoside accumulates in tissues
Clinical:
- Hypohidrosis
- acroparesthesia (debilitating burning extremity pain)
- angiokeratomas (non-blanching macules and papules between umbilicus and knees)
- Progressive renal insufficiency –> death
**Fabry loved CERAMIC HEXagons too much. He ate them and they destroyed his kidneys
WHat ligament is affected with radial head sublaxation?
-Annular ligament
histology of contact dermatitis?
-Spongiosus
What is the major morphologic sign in cardiac myocytes of early stage doxorubicin cardiomyopathy? WHat happens next? What drug prevents toxicity?
- Swelling of the sarcoplasmic reticulum
- loss of cardiomyocytes
- Prevent with Dexrazoxane
Amiodarone side effects:
- thyroid dysfunction
- corneal micro-deposits
- blue-gray skin discoloration
- hepatitis
- pulmonary fibrosis (rare but deadly)
What does MMP at a wound do?
- degradation of collagen and other ECM proteins
- encourages myofibroblast accumulation at wound edges and scar tissue remodeling (myofibroblasts initiate wound contraction)
- Too much MMP = excessive wound contraction
Hyperammonemia in hepatic encephalopathy depletes what 2 substrates?
- Alpha-keto-glutarate
- Glutamate
*Glutamine excess occurs –> neurotoxicity
Name the 3 areas involved in the micturition center and each of their functions:
- Sacral micturition center - S2-S4 –> PNS to cholinergics in bladder
- Pontine micturition center - retic. formation –> coordinates relaxation of sphincter with contraction of bladder
- Cerebral cortex - Inhibits sacral center (damage –> urge incontinence)
What is cord factor of TB? What about sulfatide?
Cord factor:
- virulence factor that allows TB to grow in parallel, serpentine chains. No cord factor = no infection
- Inactivates neutrophils, damages mitochondria, induces TNF release
Sulfatide:
-Inhibit fusion of phagosomes to lysosomes
Mutation for polycythemia vera?
- Replaces valine with phenylalanine at 617 position
- makes hematopoetic stem cells more sensitive to growth factors
- LOW EPO levels
- dont forget they can have gout and peptic ulcers (histamine from basophils)
