A little late in updating because I was finishing urology case report. My neurology exams is in next 5 days so I will be focusing on neurology also from now on. Here are the half of UW discussion I did:
- Pregnant women should be immunized by tetanus toxoid so that protective IgG can be transferred into neonate to avoid tetanus.
- In urine, the pathogens that can be found are CMV, adenovirus, E. Coli, Staph. saprophyticus, Klebsiella.
- This is probably the easies, but still I have to remember; lecithin/sphingomyelin ration > 2 indicates fetal lung maturity.
- cryptpococcosis -> capsular polysaccharide have antiphagocytic properties; stained by India ink -> round yeast with peripheral clearing.
- Listeria is the only gram +ve bacteria to produce lipopolysaccharide (LPS) endotoxin. Cell-mediated immunity is needed to eliminate listeria. It has very small zone of beta-hemolysis on sheep blood agar; catalase +ve and motile. Neonates up to 3 years, AIDS patients, pregnant and lymphoma are at high risk.
- HPV causes cutaneus (straisn 1-4) & genital warts (strains 6 & 11), benign and malignant epithelial neoplasia. Koilocytosis is the hallmark of HPV infection.Koilocyte = pyknotic superficial or immature squamous cells with dense, irregularly staining neoplasm & perinuclear clearing.
- Here are some things about antiHPTs in moderate to severe hypertension:
- Hydralazine is safe and useful in pregnancy-induced hypertension.
- Nitroprusside can cause cyanide toxicity and sodium & water retention.
- Fenoldopam is a new dopamine-1 receptor agonist. Dopamine-1 receptor stimulation activates adenylyl cyclase, increasing cAMP and vasodilation. Besides improving renal blood flow, it also increases excretion of sodium and water (natriuresis). It can be used in patients with renal insufficiency.
- Homeobox codes for DNA-binding transcription factors play role in morphogenesis.
- Power = 1 – beta; beta = probability of not seeing any difference while in reality it exists.
- Risk factors for osteoporosis: smoking, menopause, corticosteroid therapy, physical inactivity, caucasian, low BMI, alcohol. Mechanism of corticosteroid therapy in inducing osteoporosis:
- decreases GIT absorption of calcium.
- inhibits collagen synthesis by osteoblasts.
- decrease GnRH -> hypogonadism.
- increases urinary calcium loss.
- Skeletal muscles have two types – Slow Twitch (type I) and Fast Twitch (type II):
- Type I – low level sustained force for maintenance (soleus, paraspinal). Aerobic metabolism, high in myoglobin (oxygen storage) and high mitochondria.
- Type II – divides into IIa and IIb. It is responsible for rapid and forceful movements (muscles of the arm). IIb = anerobic glycogenolysis and glycolysis.
- Depolarization (phase 0) in ventricle of the heart = sodium influx. In pacemaker cells (SA and AV nodes) = calcium influx.
- Shine-Dalgarno sequence. 16s rRNA component of 30S ribosomal subunit can form complementary nucleotide sequence to the mRNA.
- Common peroneal nerve lesion causes foot drop:
- motor: superficial everts and deep dorsiflexes.
- sensory: dorsum of the foot.
- Metformin (biguanide). Side effects include Gi upset and lactic acidosis. Lactate is formed in anerobic glycolysis. Lactate then converts to glucose via GNG. GNG is inhibited by metformin. so the lactic acidosis. Contraindication of metformin:
- renal failure (creatinine > 1.4 mg/dL)
- liver dysfuction
- patients taking heart failure meds
- alcoholism
- sepsis, hypersensitivity.
