location of colorectal cancerrectosigmoid> ascending> decending
rectosigmoid→ hematochezia, obstruction, temesmus(painful straining on defecation), small-caliber stool
ascending→ large and bulky→ ☆iron deficiency anemia(bleeding is usually occult), weight loss gastrointestinalUWorld Jun 30, 2020, 11:55 PM HirotoShishido
malrotationAnomaly of midgut rotation(around ☆SMA) during fetal development in proper positioning of bowel (small bowel clumped on the right side), formation of fibrous bands (Ladd bands)→ cause duodenal obstruction→ ☆bilious emesis during the first day of life
the most common presenting symptoms of Pancoast tumor・☆shoulder pain radiating toward the axilla and scapula (involvement of the lower brachial plexus)
histology of acute eczematous dermatitis☆spongiosis
= an accumulation of edema fluid in the intracellular spaces of the epidermis
→ the intracellular bridges become more distinctive in an edematous background, and the epidermis is often described as "spongy" dermatologyUWorld Jun 30, 2020, 7:50 PM HirotoShishido
what receptor is affected by decreased ATP during cell injuryNa+-K+ ATPase,
sarcoplasmic reticulum Ca2+-ATPase
→ increased intracellular Na+ and ☆Ca2+ and increased intramitochondrial Ca2+ pathologyUWorld Jun 30, 2020, 12:40 AM HirotoShishido
oral rehydration for children with watery diarrheahypotonic, equimolar concentrations of ☆sodium and glucose solution
sodium creates osmotic gradient by active cotransportation, increasing water reabsorption from GI lumen into lamina propria and ultimately the bloodstream gastrointestinalpharmacologyUWorld Jun 30, 2020, 12:17 AM HirotoShishido
HIV-1/2HIV-1/ 2
Geographic location
Worldwide/ ☆West Africa (eg Senegal)
types of pneumoniaLobar pneumonia
☆S pneumoniae most frequently, also Legionella, Klebsiella
Intra-alveolar exudate consolidation
(Can involve the entire lobe or the whole lung)
Bronchopneumonia
S pneumoniae, S aureus, H influenzae, Klebsiella
Acute inflammatory infiltrates from bronchioles into adjacent alveoli
(usually the lower lobes or right middle lobe)
femoral herniaProtrudes below inguinal ligament through femoral canal below and lateral to pubic tubercle. More common in females.
More likely to present with incarceration or ☆strangulation(ischemia and necrosis) (vs inguinal hernia). gastrointestinalUWorld Jun 29, 2020, 7:29 AM HirotoShishido
superior mesenteric artery syndromecharacterized by intermittent intestinal obstruction symptoms (primarily postprandial pain) when SMA and aorta compress ☆transverse (third) portion of duodenum
Typically occurs in conditions associated with ☆diminished mesenteric fat (eg, low body weight/malnutrition).
→ angle between aorta and SMA diminishes to less than 20°, duodenum can get entrapped gastrointestinalUWorld Jun 29, 2020, 6:32 AM HirotoShishido
progression of type Ⅰ diabetes mellitusOvert manifestations of diabetes mellitus tend to develop once >90% of beta cells are destroyed.
Although antibodies against islet antigens are detected in a large number of patients, they are thought to play a permissive role in disease pathogenesis; the destruction of beta cells occurs primarily through ☆cell-mediated immunity. Infiltration of islets by inflammatory cells is called insulitis and is more prominent during the early stages of disease. endocrinologyUWorld Jun 29, 2020, 5:03 AM HirotoShishido
mechanism of capsaicinCapsaicin causes release and subsequent ☆depletion of substance P, a polypeptide neurotransmitter involved in transmission of pain signals.
On initial application, topical capsaicin causes burning, stinging, and erythema, but persistent exposure leads to a moderate reduction in pain overtime. neurologyUWorld Jun 29, 2020, 3:24 AM HirotoShishido
pathogenesis of diabetic neuropathyAccumulation of glycosylationend products and sorbitol altered metabolism and increased oxidative stress
☆Endoneureal arteriolar hyalinization
Occlusion of vasa nervorum with nerve ischemia
☆Length-dependent axonopathy
(short→ positive(eg pain), long→ negative(eg numbness)) endocrinologyUWorld Jun 29, 2020, 3:05 AM HirotoShishido
presentation of acromegaly☆left ventricular hypertrophy,
☆hypertrophic arthropathy(hyperplasia of articular chondrocytes and synovial hypertrophy→ degeneration of articular cartilage and periarticular bone),
prognathsm,
carpal tunnel syndrome,
↑ risk of colorectal polyps and cancer,
diaphoresis endocrinologyUWorld Jun 29, 2020, 2:09 AM HirotoShishido
pathogenesis/ presentation/ complications/ treatment of pituitary apoplexyAcute pituitary hemorrhage
Usually occurs in preexisting adenoma
treatment for diabetes insipidus(DI)central DI
desmopressin, hydration
nephrogenic DI
☆hydrochlorothiazide(HCTZ), NSAIDs(indomethacin)→↑aquaporin2, amiloride→lithium, hydration, dietary salt restriction
Thiazides appear to reduce renal water losses in NDI by inducing a mild volume depletion that ☆increases sodium and water reabsorption in the proximal tubule.
Infants with NDI cannot freely replace ongoing water losses, and early treatment is essential for preventing associated mental and physical growth retardation. endocrinologyUWorld Jun 28, 2020, 7:06 AM HirotoShishido
