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DIT 2009 WK 3
Q&A from DIT emailed questions WK 3
| Question | Answer |
|---|---|
| Rate-limiting enzymes for glycogen synthesis (Gluconeogenesis) | Fructose 1-6 Bisphosphatase |
| Rate-limiting enzymes glycogen breakdown (Glycolysis) | PFK-1 |
| Rate-limiting enzymes fatty acid synthesis | Acetyl-CoA carboxylase (ACC) |
| Rate-limiting enzymes fatty acid oxidation | Carnitine acyltransferase I |
| Adrenergic antagonists used to treat hypertension and urinary retention in pts with benign prostatic hyperplasia (BPH) | Prazosin (alpha 1 selective) |
| Risk factors for colon cancer | colorectal villous adenomas, chronic IBD (especially ulcerative colitis, inc with age), FAP, HNPCC, past medical or family history; screen patients >50 yrs of age with stool occult blood test and colonoscopy |
| What is prevalence? | Tot amnt of cases in population at a given time/total pop at risk at a given time |
| What is incidence? | New cases over a given time/tot pop risk at that time |
| Relationship between prevalence and incidence for chronic diseases | Prevalence > Incidence |
| Relationship between prevalence and incidence for acute diseases | Prevalence = Incidence |
| What physiology accounts for the automaticity of the AV and SA nodes? | - Phase 4: slow diastolic depolarization – membrane potential spontaneously depolarizes as Na conductance increase, accounts for automaticity of SA and AV nodes. The slope of phase 4 in the SA node determins HR |
| How does the emphysema caused by smoking differ from the emphysema caused by alpa-1-antitrypsin deficiency? | Smoking emphysema is known as centriacinar, whereas alpha-1-antitrypsin def will result in panacinar emphysema (accompanied by liver cirrhosis) |
| What is the difference between Meissner’s corpuscle and a Pacinian corpuscle? | *Meissner’s: found on glabrous (hairless) skin; sense dynamic fine touch, adapt quickly *Pacinian: found in deep skin layers, ligaments, and joints; sense vibration & pressure |
| What syndrome causes the triad of sterility, bronchiectasis, and recurrent sinusitis? | Kartagener's Sx |
| What is the primary defect in Kartagener's syndrome? | Dynein arm defect causing in immotile cilia, resulting in infertility do to immotile sperm, bronchiectasis |
| In which glomerular disease would you expect to see foot process effacement (electron microscope)? | Minimal Change |
| In which glomerular disease would you expect to see wire-loop appearance (light microscope) | Diabetic GN, Diffuse proliferative GN (due to SLE) |
| In which glomerular disease would you expect to see mesangial deposits of IgA (electron microscope) | IgA Glomerulopathy (Berger's Dz) |
| In which glomerular disease would you expect to see crescent-moon shaped lesion (light microscope) | Rapidly progressive (crescentic) GN |
| In which glomerular disease would you expect to sesegmental sclerosis and hyalinosis (light microscope) | Focal Segmental Glomerulosclerosis |
| Clinical scenario most commonly seen in Reye’s syndrome | Rare, often fatal childhood hepatoencephalopathy, microvesicular steatosis, hypoglycemia, coma |
| What are the characteristics of Reye's Sx? | Associated with viral infection (especially VZV and Flu-B) that has been treated with salicylates |
| What would you expect to find in the synovial fluid of a pt with gout? | Will have precipitation of monoscodium urate crystal (not uric acid!!) due to hyperuricemia. Crystals are needle shaped and negatively birefringent. MC in men |
| What would you expect to find in the synovial fluid of a pt with pseudogout? | caused by deposition of calcium pyrophosphate crystals. Crystals are basophilic, rhomboid shaped and weakly positively birefringent, more common in large joints (like knee). No sex prevalence |
| What effects do prostaglandins have on platelet aggregation? | Prostacyclin decreases platelet aggregation and promotes vasodilation (- Prostaglandins promote pain, uterine tone, T, and gastric mucosa decreasing vascular tone) |
| What effects does thromboxane have on platelet aggregation? | Thromboxane (TXA2) promotes platelet aggregation and vasoconstriction |
| When is a fetus most susceptible to damage from teratogens? | 3rd – 8th week of pregnancy |
| What drug used in the treatment of hypertension is a teratogen? | ACE inhibitors - renal damage |
| Give the mechanism and time frame for hyperacute transplant rejection? | Mech: preformed antidonor ab's in transplant recipient Time: minutes |
| Give the mechanism and time frame for acute transplant rejection? | Mech: cell mediated - cytotoxic T lymphocytes Time: weeks (reversible) |
| Give the mechanism and time frame for chronic transplant rejection? | Mech: Tcell & ab-mediated vascular damage Time: Mo's to Yrs (irreversible) |
| What is Zollinger-Ellison syndrome? | - Gastrin-secreting tumor of pancreas or duodenum, recurrent ulcers, associated w/ MEN 1. RX: Octreotide |
| What type of collagen is abnormal in patients with Alport’s syndrome? | Type IV Collagen |
| Order elimination with rate of elimination proportional to the drug concentration? | 1st Order |
| What is the most common tumor of the adrenal medulla in adults? | Pheochromocytoma |
| What is the most common tumor of the adrenal medulla in children? | Neuroblastoma |
| What lab abnormalities would you expect to see in a pt with SIADH? | - Too much ADH will cause excessive water retention, hyponatremia (retaining salt, can lead to seizures), urine osmolarity > serum osmolarity (concentrating urine) |
| What drugs are used in the treatment of Parkinson’s disease? | - BALSA: Bromocriptine (pramipexole, ropinorole), Amantidine (SE: ataxia), L-dopa/carbidopa (B6 decrease effectiveness), Selegiline (Tolcapone), Anti-Muscarinic (Benztropine) |
Created by:
snezya24
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