germ cell tumor
15-30 yo (peak of reproduction) ->ovarian tumor.
benign surface epithelium
cystadenoma
30-40 (premenopausal but past prime)->ovarian tumor
malignant surface epithelium
cystadenocarcinoma
postmenopausal women->ovarian tumor
queyrat erythroplasia
glans->squamous cell carcinoma precursor lesion
bowen disease leukoplakia
penis shaft->squamous cell carcinoma precursor lesion
bowenoid papulosis
reddish papules on skin of penis->squamous cell carcinoma precursor lesion
Diffuse large b cell lymphoma
bilateral Testicular Cancer in a male > 60yo
tamsulosin
terazosin or tamsulosin?
selective alpha 1a antagonist for BPH in a normotensive patient
terazosin
terazosin or tamsulosin?
alpha 1 antagonist for BPH in conjunction with hypertension
posterior periphery
Prostatic adenocarcinoma->what region of prostate?
10ng/dl
A PSA of what is worrisome of prostate cancer at any age?
1-4ng/dl
PSA increases with age. What is the normal range?
bound PSA
free PSA?bound PSA
Which does cancer tend to make?
architecture
Nuclear atypia or architecture?
Prostate adenocarcinoma gleason grade
lumbar spine
Where does prostate cancer spread?
Prostate adenocarcinoma
?->Osteoblastic metastasis->sclerosing bone lesion
lateral forearm
Sensory: c5-c7 musculocutaneous nerve
c5-t1 radial
Sensory posterior arm?
c5-t1 radial
Sensory posterior forearm?
c8-t1 ulnar
sensory medial forearm?
c5-7 musculocutaneous
arm flexors
nerve?->+sensory lateral forearm
?
motor?
external carotid
maxillary
pterion
1) artery->2)artery->middle meningeal artery=
3)under what part of the skull?
ACE inhibitor
ACE inhibitor or Thiazide?
LONG TERM control of Hypertension in a patient with CHF
myosin
actin or myosin?
Phosphorylated->Contraction
s2-4 pudendal
ischial spine
What nerve is blocked during labor?
What is the landmark?
l2-4 genitofemoral
sensory: scrotum
l2-4 genitofemoral
sensory: labia majora
l2-4 genitofemoral
sensory: femoral triangle skin
t12-l1 iliohypogastric
sensory: iliac crest skin
CNIX
sensory: tympanic membrane inner surface
CNIX
sensory: upper pharynx
CNIX
sensory: middle ear cavity
inferior salivatory
CNIX
Otic
Parasympathetic Nucleus->nerve->ganglion->
parotid secretion.
Nucleus?
Nerve?
Ganglion?
superior salivatory
CNVII
Submandibular
Parasympathetic Nucleus->nerve->ganglion->
submandibular gland secretion.
Nucleus?
Nerve?
Ganglion?
superior salivatory
CNVII
Submandibular
Parasympathetic nucleus->nerve->ganglion->
sublingual gland secretion.
Nucleus?
Nerve?
Ganglion?
CNXII
Motor: tongue protrusion
CN IV
diplopia when walking down stairs or reading newspaper.
Where is the lesion?
K+ sparing diuretic
Amiloride
thiazide diuretic
indapamide
ergonovine
prinzmetal angina
drug?+5HT2=Gq
?................?
+alpha1?corovary artery vasoconstriction=?
atrial natriuretic peptide
protein?localized cardiac atrium amyloidosis
prolactin
protein?localized pituitary amylodosis
beta amyloid protein
protein?localized cerebral vessel amylodosis
amylin islet amyloid protein
protein?localized pancreas islet amyloidosis
calcitonin
protein?localized thyroid amyloidosis
Fenoldopam
D1 Gs
Drug?
?
receptor??XSevere Emergency Hypertension
?
Increased renal perfusion via dilation
CD43
X linked Wiskott Aldrich
T cell/Platelet
?
1)?=actin filament?microvescicle
?
X 2)?
mannose 6 phosphate
LYST
chediak higashi
Phagocyte?Golgi?lysosome protein-1)tag?
?2)shuttle protein?lysosome?bacteria lysis
.......X
.......?
3) disease?
ataxia telangiectasia
B cell?cell cycle kinase?+cell cycle
................X
................?
...............?
HSP
Hemolytic Uremic Syndrome (HUS) or Henoch Schonlein Purpura (HSP)?
joint pain
clindamycin
metronidazole or clindamycin?
Covers anaerobes AND S. pneumoniae
trazodone
antidepressant->priapism
TCA
amoxapine
t(11;14) mantle cell lymphoma
CLL/SLL
c myc burkitt lymphoma
Bcl5 Germinal Center B cell DLBCL
t(14;18) follicular lymphoma
BCL10 Marginal Zone lymphoma
CLL/SLL
BCR signal Activated B cell DLBCL
multiple myeloma
glucuronosyl transferase
OATP1b1
fibrate
superficial inguinal
calf
popliteal
Lymph drainage: skin inferior to umbilicus including anus inferior to dentate? What area is the exception? Where does it drain?
abdominal aorta nodes
Lymph drainage: testicles
internal iliac
external iliac
sacral
Major site of prostate lymphatic drainage?
Minor site?
external iliac
Lymph drainage: superior portion of bladder
internal iliac
Lymph drainage: inferior portion of bladder
inferior mesenteric
Lymph drainage: sigmoid colon
ulnar
ulnar or median nerve?
hypothenar
HDL
+LCAT cholesterol esterification
ApoA-I
Particle:
Function:
chylomicron
enterocyte chylomicron synthesis
ApoB-48
Particle:
Function:
LDL
Extrahepatic LDL uptake
ApoB-100
Particle:
Function:
Chylomicron
HDL
LPL activation
ApoC-II
Particle:
Function:
chylomicron/VLDL
hepatic particle uptake
ApoE-3&4
Particle:
Function:
body touch
VPL
??medial lemniscus?thalamic nucleus?
VPM
Face Pain/Temp; Face touch?CNV?thalamic nucleus?
vision
Lateral geniculate thalamus
hearing
medial geniculate thalamus
VPM
insula
Parietal operculum
Taste?thalamic nuclei??cortex area?
chorda tympani CNVII
Nerve: Anterior 2/3 tongue Gustatory
CNIX
Nerve: Posterior 1/3 tongue gustatory
CNX
Nerve: Posterior area tongue root
CNV3
Nerve: P+T and Touch anterior 2/3 tongue
CNIX
Nerve: P+T and touch posterior 1/3 tongue
CNX
Nerve: P+T and touch posterior area tongue root
palatoglossus
CNX
What is the one tongue muscle not innervated by CNIX? What nerve?
phrenic nerve
Nerve: sensory mediastinal+diaphragmatic pleura
posterior cord c6-8 thoracodorsal
Nerve: latissimus dorsi
C5 dorsal scapular
Nerve: rhomboid major
c6-7 subscapular
Nerve: teres major
c5-7 long thoracic
Nerve: serratus anterior
c5-t1 recurrent branch median
c8-t1 deep branch ulnar
Nerve damage->X finger abduction
c8-t1 deep branch ulnar
nerve damage->X thumb adduction
L5-S2 inferior gluteal
gluteus maximus
X nerve -> X muscle ->
X climbing stairs/rising from seated position
L4-S1 superior gluteal
gluteus medius/minimus
X nerve->X muscle->
patient leans toward unaffected side in gait and standing on foot of affected side.
diazoxide
drug
?
+k+ channel=hyperpolarize
......................?
......................X Ca2+ channel=VasoDilation
hydralazine
drug?X IP3?X SR Ca2+=vasoD
?
+Ca2+ activated K+ channel
?
hyperpolarization?X Ca2+ channel=VasoD
marijuana
Illicit drug use->conjunctival injection (red eye)
PCP
Illicit drug use->nystagmus+ataxia
ketamine
Illicit drug use->hypersalivation
gamma hydroxybutyrate
psychadelic drug->X memory storage
5HT2 Gq
Illicit drug use->receptor?->hallucination