pathologic process in liver cirrhosisLiver fibrosis occurs when the sinusoidal ☆stellate cells are activated by cytokines, inflammatory cells, and other stimuli. Persistent activation of stellate cells
→differentiate into a myofibroblast upon injury and plays a large role ln the production of fibrosis in cirrhosis
(nodules of a cirrhotic liver are composed of ☆hepatocytes)
Southwestern blotidentify and isolate proteins that bind DNA
DNA binding protein→ ☆c-Jun, c-Fos
(proto-oncogenes)
= leucine zipper motif
→☆transcription factor that contains 30 amino acld alpha helical segment that consists of repeated leucine residues at every 7 position geneticsUWorld SIM2UWorld HirotoShishido
cerebral edema
etiology①cytotoxic edema begins hours after the ischemic injury. The ☆failure of ATP-dependent ion pumps leads to the accumulation of intracellular Na+ and water in neural and glial cells despite an intact blood-brain barrier.
②Vasogenic edema follows 24-48 hours later, when the release of inflammatory mediators disrupts the tight junctions of the blood-brain barrier, allowing proteins (eg, albumin) and water to enter the interstitial space.
☆neoplastic lesion can also disrupt
BBB neurologyUWorldUWorld SIM2 HirotoShishido
mechanism of insulin resistance
effects of insulin on GLUT-4 proteinphosphorylation of ☆serine and threonine residues of insuline receptor leads to insulin resistance
(phosphorylation can be induced by ☆TNF-α, catecholamines, glucocorticoids, and glucagon)
☆increased translocation of the transporters to the cell membrane (this process is activated by PI3K pathway)
→ increase glucose uptake endocrinologyUWorldUWorld SIM2 HirotoShishido
dilated cardiomyopathy
etiologiesSCD from ventricular arrythmia ⇔ HCM→SCD during exertion in young
the global hypokinesis of the left ventricle leads to stangnation of blood flow and ☆LV mural thrombus
AICM (→☆enlarged cardiac ventricles with mild myocardial hypertrophy and inverstitial fibrosis) is reversible if ethanol intake is stopped prior to the development of fibrosis cardiologyUWorld SIM2UWorld HirotoShishido
disease caused by missense mutationsickel cell anemia, ☆MCAD deficiency
usual acidic(negatively chrged) glutamic acid residue is replaced by a nonpolar(neutral charge) valine residue, forming HbS
this leads to the formation of a ☆hydrophobic pocket on the beta globin surface that interacts with a complementary nonpolar residue on another hemoglobin molecule→
this causes polymerization of HbS molecules and subsequent erythrocyte sickling
what symptoms have higher specificity for Graves disease☆pretibial myxedema, proptosis(Graves orbitopathy)
Graves ophthalmopathy are not mediated by thyroid hormone or adrenergic stimulation and ☆do not respond to beta blockers. However, they are immune mediated, the manifestation usually respond to glucocorticoid therapy.
fibroblasts stimulated by TRAb secrete excess amount of ☆glycosaminoglycans (eg hyaluronic acid) along with adipogenesis, which expand ground substance of retro-orbital tissues
→desiccation(eg a sense of ☆grittiness), tearing endocrinologyUWorldUWorld SIM2 HirotoShishido
vitamin A functionnormal differntiation of epithelial cells into specialized cells (☆mucus-secreting cells)
(→ ☆normalize follicular keratinization)
Common opportunistic causes of diarrhea in HIV patients・cytomegalovirus
☆multiple ulcers and mucosal erosions
giant cells with large ovoid nuclei containing centralized intranuclear basophilic inclusions (owl's eyes appearance)
as with all herpesvirus family, ☆latent infection is established after resolution of the initial infection