Notes taken from various question banks 4/13/2009 http://conceptclues.blogspot.com/ 1 Part 1

Important points about Cystic Fibrosis Mutation = CRX7 → CFTR gene CFTR Binds ATP Regulated by protein kinase A phoshporylation Symptoms Recurrent lung infections Pancreatic insufficency Malabsorption Foul smelling stool Screening = sweat test 4/13/2009 http://conceptclues.blogspot.com/ 2

Increase hydrostatic bowman capsule = ↓GFR = post-renal failure 4/13/2009 http://conceptclues.blogspot.com/ 3

Dilating Efferent Arteriole = ↓in glomerular hydrostatic pressure = ↓GFR 4/13/2009 http://conceptclues.blogspot.com/ 4

↑ plasma oncotic pressure = draws fluid from bowmans capsule into capillaries = ↓GFR 4/13/2009 http://conceptclues.blogspot.com/ 5

Dilating afferent arteriole = ↑glomerular capillary pressure = ↑GFR 4/13/2009 http://conceptclues.blogspot.com/ 6

Points to remb about Transient Ischemic Attack Sign of impeding stroke Typically occurs > 60 years old Temp decreases or stops blood flow to particular brain areas Symptoms do not last longer than 24 hours: Aphasia Hemiparesis Loss of vision Loss of consciouness Paresthesia 4/13/2009 http://conceptclues.blogspot.com/ 7

UTI + positive leukocyte esterase + nitrite negative = enterococcus fecalis or staphlococcus saprophyticus 4/13/2009 http://conceptclues.blogspot.com/ 8

Quite Breathing Inspiration = diaphragm Expiration = passive 4/13/2009 http://conceptclues.blogspot.com/ 9

Muscles of Inspiration Most important = diaphragm Others = primary use During exercise ↑ airway resistance = asthma External intercoastal muscles Function: moves ribs upward & outward Accessory muscles Scalene muscle Sternocleido mastoid muscle Function: elevates 1st two ribs and sternum 4/13/2009 http://conceptclues.blogspot.com/ 10

Muscles of Expiration Most imporant: passive breathing Other are used for: Exercise ↑ airway resistance = asthma Internal intercoastal muscles Function: pulls rib downward / inward Abdominal Muscles: Rectus abdominus Int/ext obliques Transversus abdominis Function: helps push diaphragm up during exercise or ↑ airway resistance, asthma 4/13/2009 http://conceptclues.blogspot.com/ 11

Honey = clostridium botulism = lysogenic phage genom = infant botulism = flaccid paralysis = block of Ach release from cholinergic synapses 4/13/2009 http://conceptclues.blogspot.com/ 12

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Vaginal Candidiasis Cottage cheese Germ test tube = pseudohyphae Symptoms: Vulvovaginal erythema Edema itching Risk Factors: Diabetes Systemic antibiotics Pregnancy Obesity Decreased immunity 4/13/2009 http://conceptclues.blogspot.com/ 14

Hematopoiesis @ different stages 4/13/2009 http://conceptclues.blogspot.com/ 15

Subarachnoid Hemorrhage MC cause = berry aneurysm Worst Headche of life Associated with: Marfans Ehlers-Danlos Acute Polycystic Kidney HTN Smoking 4/13/2009 http://conceptclues.blogspot.com/ 16

Epidural Hematoma Traumatic Rupture of middle artery after skull fracture Lucid intervals before loss of consciousness 4/13/2009 http://conceptclues.blogspot.com/ 17

Subural Hematoma Caused by trauma Rupture of bridging veins 4/13/2009 http://conceptclues.blogspot.com/ 18

Intracerebral Hemorrhage HTN Trauma Ischemia Infarction 4/13/2009 http://conceptclues.blogspot.com/ 19

Kimmelstiel – Wilson Disease Proteinuria ( nephrotic syndrome ) Nodules PAS + deposit of mesangial matrix Thickened Basement Membrane 4/13/2009 http://conceptclues.blogspot.com/ 20

Spinal Nerve Compression @ Cervical level Pain Burning Tingling Sensation Weakness Numbness: Shoulders Arms Hands 4/13/2009 http://conceptclues.blogspot.com/ 21

Close Angle Glaucoma Rapid onset sever pain Profound visual loss = halos around light Red eyes w/ steamy cornea Dilated pupils Hard eyes IV Tx: Acetazolamide (carbonic anhydrase inhibitor)– 250mg PO qid 4/13/2009 http://conceptclues.blogspot.com/ 22

Cutaneous Antrax Boxcar Shaped = black necrotic tissue w/ a erythematous ring (eschar) G+ rods = aerobic spore forming Bacillus Antrax Tx. Ciprofloaxcin or Doxycycline 4/13/2009 http://conceptclues.blogspot.com/ 23

DIC Persistent activation of both coagulation and fibrinolytic system Low platelets Low fibrinogen Increased PT/PTT 4/13/2009 http://conceptclues.blogspot.com/ 24

Neonatal Sepsis Pneumonia Meningitis = E.coli ↓ G + oxidase negative lactase fermenting rod = pink colony → MacConkey Agar ↓ Capsule = K1 serotype 4/13/2009 http://conceptclues.blogspot.com/ 25

Carbohydrate Chains ↓ are transferred to protein component of albumin ↓ attached to dolichol 4/13/2009 http://conceptclues.blogspot.com/ 26

Hypersecretory gastritis = marked hyperplasia of chief cells & parietal cells 4/13/2009 http://conceptclues.blogspot.com/ 27

Reiters Syndrome Due to previous infection with: shigella Salmonella Yersinia Chlamydia Campylobacter 4/13/2009 http://conceptclues.blogspot.com/ 28

Point to remember about Good Pastures Anti-Basment Membrane antibody Type 4 collagen Affected: lungs kidneys = key = biopsy → ribbon like pattern 4/13/2009 http://conceptclues.blogspot.com/ 29

Infected with HIV now becoming Symptomatic Points to remember Increase Virus ↑ P24 antigen ↑ Viral RNA ↑ CD4 count ↓ dramatically Antibody to P24 ↓ ↑ of IgM antibody to envelope antigens 4/13/2009 http://conceptclues.blogspot.com/ 30

VHL points to remember Autosomal Dominant Retinal angioma CNS hemagioblastoma esp cerebellum ½ = multiple bilateral renal cell carcinoma ½ = tumors A/W deletion of VHL gene on chromosome 3p 4/13/2009 http://conceptclues.blogspot.com/ 31

Case Control = Odds ratio to estimate risk = an observational study information for new diseases so appropriate treatment can be given 4/13/2009 http://conceptclues.blogspot.com/ 32

Tuberous Sclerosis = adenoma sebaceum of skin & cortical tubers 4/13/2009 http://conceptclues.blogspot.com/ 33

Reaction Formation = unacceptabe transformed into opposite = girl having sexual dreams becomes nun 4/13/2009 http://conceptclues.blogspot.com/ 34

Identification = unconsious adoption of someones traits or activites = dead friends jacket is worn by best friend 4/13/2009 http://conceptclues.blogspot.com/ 35

Displacement = transfer of emotion = fight with boss → kicks dog 4/13/2009 http://conceptclues.blogspot.com/ 36

Rationalization = unconsciously giving false but acceptable explanation of behavior 4/13/2009 http://conceptclues.blogspot.com/ 37

Regression = elderly acting like child 4/13/2009 http://conceptclues.blogspot.com/ 38

Uncal herniation = compression of CN 3 (occulomotor nerve) 4/13/2009 http://conceptclues.blogspot.com/ 39

H.Pylori = damages gastric mucosa = by ↑ing Ammonia levels 4/13/2009 http://conceptclues.blogspot.com/ 40

Ammonia = cytotoxic = directly damages epithelial stomach cells = ↑ gastric mucosa permeability = precursor to ulcer formation 4/13/2009 http://conceptclues.blogspot.com/ 41

Key points to know if you loose one kidney ↑ TPR → b/c organs are arranged in parallel so if u remove an parellel resistance than u will get an increase in TPR and b/c CO is inversely proportional, ↓ in C0 ↓ in Cardiac Output ( CO ) Arterial pressure is normal if working kidney is functioning properly Total RBF ↓ b/c only one kidney left 4/13/2009 http://conceptclues.blogspot.com/ 42