Rx for neutropenia that causes pulmonary edema, pain, vomiting, rash
sargramostim (GM-CSF)
glucokinase defect
decreased glucose sensing --> decreased insulin secretion
hereditary angioedema
C1 esterase inhibitor deficiency (ACE inhibitors counter-indicated)
uncoordinated esophageal spasm with angina-like symptoms
diffuse esophageal spasm
non-bizarre delusion for at least one month with no other psych sx
delusional disorder
3rd pharyngeal pouch
thymus
inferior parathyroids
4th pharyngeal pouch
superior parathyroids
1st pharyngeal pouch
middle ear and auditory tube epithelium
2nd pharyngeal pouch
palatine tonsil epithelium
thymus abnormalities
myasthenia gravis
why does blood arriving at the right atrium have a slightly lower O2 content than blood in the pulmonary capillaries?
venous admixture: blood from bronchial veins returns to the right heart via the azygous, hemiazygous, and intercostal veins (although most of the blood from the bronchi is returned to the left heart)
superficial inguinal nodes
all skin from the umbilicus down, external genitalia, anus below the pectinate line
function of inhibin
negative feedback on FSH secretion from anterior pituitary
products of sertoli cells
anti-mullerian hormone
androgen binding protein
inhibin
hormone levels in klinefelter syndrome (XXY)
decreased testosterone and inhibin
increased FSH and LH
derivatives of rathke's pouch
anterior pituitary
cranipharyngioma (calcified cystic tumor)
two lab values that, when elevated, contribute to insulin resistance
free fatty acids
triglycerides
raphe nuclei
serotonin
nucleus ceruleus
norepinephrine
nucleus basalis of Meynert
acetylcholine
red nucleus
motor coordination of upper extremities
cause of increased end-diastolic sarcomere length in the myocardium
increased preload (e.g. isotonic saline infusion)
thromboembolisms, marfanoid habitus, improvement with vitamin B6
homocystinuria
aneurysm of either of these arteries can cause CN III palsy by compressing the nerve as it exits the midbrain
posterior cerebral artery
superior cerebellar artery
derivatives of metanephric mesoderm
bowman's space
glomerulus
nephron
derivatives of ureteric bud
collecting duct
calyces
renal pelvis
ureters
part of nephron impermeable to water
ascending loop
17-hydroxycorticosteroids in urine
11beta hydroxylase inhibition (hypertension, low aldosterone, low cortisol, increased sex hormones)
elevated actylcholinesterase in amniotic fluid
neural tube defect (also: elevated alpha-fetoprotein)
amino acid that is a nitrogen source for urea in the urea cycle
aspartate
embryologic origin of CNV maxillary and mandibular branches
1st branchial arch
1st pharyngeal pouch derivatives
middle ear
eustachian tubes (mesoderm)
mastoid air cells
2nd pharyngeal pouch derivatives
epithelial lining of the palatine tonsil
3rd pharyngeal pouch derivatives
thymus (endoderm)
inferior parathyroids (endoderm)
4th pharyngeal pouch derivatives
superior parathyroids (endoderm)
5th pharyngeal pouch derivatives
parafollicular cells of medullary thyroid
pygmalion bias
researcher's belief in treatment changes outcome of treatment
hawthorne bias
group being studied changes behavior d/t knowledge of being studied
risk factors for HPV
multiple partners (most important)
smoking
early intercourse
HIV
enzymes important for carcinoma to invade, become metastatic
metalloproteinases (collagenase, hydrolase)
increased homovanillic acid in urine
adrenal medulla tumor (neuroblastoma, pheochromocytoma)
cancers caused by smoking
laryngeal (squamous cell)
lung (squamous and small cell)
kidney (renal cell)
bladder (transitional cell)
neoplasm with inc EPO
renal cell
hepatocellular
pheochromocytoma
hemangioblastoma
neoplasm with inc ACTH
small cell lung cancer
neoplasm with inc PTH-related peptide
squamous cell lung ca
renal cell ca
breast ca
neoplasm with inc ADH
small cell lung ca
intracranial
neoplasm with muscular weakness (Lambert-Eaton syndrome)
small cell lung ca
thymoma
immature teratoma
aggressive, males, fetal demise
mature teratoma
benign, females, ovarian cyst
struma ovarii
teratoma containing mature thyroid tissue, causing sx of hyperthyroidism
bone mets
prostate (blastic), breast (blastic or lytic) > lung (lytic) > testes, thyroid
causes of elevated alpha-fetoprotein
neural tube defect
hepatocellular carcinoma
non-seminoma germ cell tumor (yolk sac or mixed embryonal)
biceps reflex nerve root
C5/6
triceps reflex nerve root
C7
patellar reflex nerve root
L4
achilles reflex nerve root
S1
deficiency of this hormone causes decreased bone density
estrogen
pupillary reflex (afferent/efferent)
II / III
corneal reflex (afferent/efferent)
V-1(nasociliary) / VII(temporal)
lacrimation reflex (afferent/efferent)
V-1 / VII (V-1 lesion does not preclude emotional tears)
jaw jerk reflex (afferent/efferent)
V-3 / V-3
gag reflex (afferent/efferent)
IX / IX, X
normal serum calcium and phosphate, with increased alk phos
Paget's
increased serum calcium and alk phos with decreased phosphate
hyperparathyroidism (osteitis fibrosis cystica, "brown tumors")
microspherocytes
autoimmune hemolytic anemia
extravascular hemolysis
hereditary spherocytosis
pyruvate kinase deficiency
sickle cell anemia
IgG and IgM autoimmune hemolytic anemia
penicillin and methyldopa induced immune hemolysis
transfusion reaction
intravascular hemolysis
paroxysmal nocturnal hemoglobinuria
G6PDase deficiency
some IgM autoimmune hemolytic anemia
quinidine-induced immune hemolytic anemia
malaria
mechanical (prosthetic valves, stenosis, etc.
microangiopathic (DIC, TTP, HUS, SLE, malignant hypertension)
RBC basophilic stippling
chronic disease
lead posioning
iron deficiency
thalassemias
bite cell
G6PDase deficiency
PMNs with > 5 segments
B12 or folate deficiency
schistocyte/helmet cell
DIC
TTP
HUS
mechanical hemolysis
tear drop RBC
myelofibrosis
heinz bodies
alpha thalassemia
G6PDase deficiency
howell-jolly bodies
hyposplenia or asplenia
case control study
compares diseased to non-diseased, looking for prior exposure or risk factor (retrospective)
cohort study
compares exposed to non-exposed, looking at likelihood of disease (prospective or retrospective)
case series
tracks small group of patients with a known exposure and examines their outcome (prospective or retrospective)
interstitial lung inflammation with loose non-caseating granulomas
hypersensitivity pneumonitis (hypersensitivity reaction often seen in farmers, people exposed to birds)
cause of menopause sx
fewer oocytes --> decreased estrogen
autoregulation of blood flow to heart
NO, adenosine, decreased O2
autoregulation of blood flow to skeletal muscle
K+, lactate, adenosine
autoregulation of blood flow to brain
CO2 (pH)
increased fremitus
consolidation (pneumonia)
glomerular injury d/t neutrophils
nephritic syndrome
glomerular injury d/t cytokines
nephrotic syndrome
increased BUN/Cr ratio
� pre-renal renal failure (aka pre-renal azotemia)
� renal failure due to decreased renal blood flow
� urea is retained (with H20 and Na) in attempt to conserve volume.
decreased BUN/Cr ratio
� intrinsic renal
� renal failure due to acute tubular necrosis > glomerulonephritis
� urea is excreted d/t impaired reabsorption
superior vena cava syndrome
feeling of fullness in head and neck, usually secondary to compression by upper lobe lung/mediastinal mass
reversible cell damage
dec ATP synth
impaired Na/K pump --> cell swelling
chromatin clumping
ribosomal detachment --> dec protein synth
dec glycogen
fatty change
irreversible cell damage
nuclear pyknosis, karryorhexis
Ca influx --> caspase activation
plasma membrane damage
lysosome rupture
increased mitochondrial permeability --> cytochrome C release --> caspase activation
fatty infiltration of bone marrow
aplastic anemia
huntington's lesion
striatum
hemiballismus lesion
subthalamic nucleus
infante with somnolence, vomiting, cerebral edema, decreased BUN, hyperammonemia
ornithine transcarbamoylase deficiency
infantile cataracts, doesn't track objects, absent social smile
galactokinase deficiency
infantile cataracts, hepatomegaly, jaundice, failure to thrive
uridyltransferase deficiency
causes of Down syndrome
1) meiotic nondisjunction (95%)
2) unbalanced robertsonian translocation (extra arm on Ch 21)
3) mosaic trisomy 21
treatment of hyperammonemia (HCV, urea cycle deficiency)
limit protein in diet
benzoate, phenylbutarate (bind a.a.'s, increased aa exretion)
lactulose (acidify GI tract, trap NH4 for excretion)
effect of hyperammonemia on metabolism
decreased alpha ketoglutarate, inhibiting TCA cycle
Tay-Sach's (enzyme, accumulated substance)
hexosaminidase, GM2 ganglioside
metachromatic leukodystrophy (enzyme, accumulated substance)
arylsulfatase, cerebroside sulfate
fabry's (enzyme, accumulated substance)
alpha-galactosidase, ceramide trihexoside
krabbe's (enzyme, accumulated substance)
beta-galactocerebrosidase, galactocerebroside
gauche's (enzyme, accumulated substance)
glucocerebrosidase, glucocerebroside
niemann-pick
sphingomyelinase, sphingomyelin