Monday, February 22, 2010

QBank notes: 2/22/2010 [48]

Rhabdomyomas (present with signs of cardiac outflow obstruction) are associated with tuberous sclerosis: cortical tubers, adenoma sebaceum, epilepsy, mental retardation.

Chediak-Higashi: infection susceptibility, albinism.

Neural ectoderm: oligodendrocytes, astrocytes, epndymal cells.

Yersinia enterocolitica: pediatric diarrhea with blood and pus "mini epidemics;" mimics appendicitis, mesenteric lymphadenitis; Yersinia can grow at 4C, so common in cold climes.

Bordetella pertussis secretes 4 toxins: (1) Pertussis toxin -- in addition to causing the whooping cough, inactivates the inactivator of cAMP (Gi) resulting in lymphocytosis, increased insulin secretion (hypoglycemia), and increased sensitivity to histamine; (2) extracellular adenylate cyclase -- somehow weakens neutrophils, lymphocytes, and monocytes; (3) filamentous hemagglutinin -- better binding to ciliated epithelial cells; (4) tracheal cytotoxin -- kills ciliated epithelial cells.

Middle third of esophagus: contains both striated AND smooth muscle.

VIPoma: diarrhea due to excess Na, Cl secretion; lowered stomach acid secretion.

Drug-induced lupus: antihistone antibody. It's not HIPP to have lupus. Hydralazine, INH, Phenytoin, Procainamide.

Posterior mediastinum -- DATES: descending aorta, azygos and hemiazygos vein, thoracic duct, esophagus, sympathetic trunk.

Draining of colorectal cancer. Below the pectineal line: superficial inguinal. Above the pectineal line: internal iliac.

Cerebral aqueduct of Sylvius -- mesencephalon.

Steroids and thyroxine promote surfactant production. Insulin suppresses (maternal diabetes a risk factor for RDS).

Ionic effects on heart
Hyperkalemia: Tall T waves
Hypercalcemia: Shorter QT interval, almost absent ST; elevated BP, vomiting
Hypermagnesemia: Prolonged PR, QT; hypotension, respiratory depression; impaired Ach release (muscle weakness)

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