Thrombotic Thrombocytopenic Purpura

o Impaired ADAMTS13, vWF cleaving protease.

o Uncleaved vWF multimers result in microvascular
thrombosis.
o Thrombocytopenia and hemolytic anemia with schistocyte
formation occur.
DIC
o Prolonged PT, PTT
o Thrombosis, bleeding.
EBV
o Mature B lymphocytes
o Heterophile +
o IGM antibodes, horse/sheep RBC
Umbilical Hernia
o Incomplete closure of the umbilical ring, allow bowel
through abdomen.
o Covered by skin
o Reducibe buglge at the umbilicus with increase abdominal
pressure
o Associated with Downs
o Resolve by itself
Tonic clonic and absence seizure
o Valproate is used here
o Phenobarbital is used for tonic clonic only
Gouty Arthiritis
o We give them Xanthine oxidase inhibitors, which decrease
uric acid production.
o Prophylactic therapy is intiated.
Cystic Fibrosis
o Amino acid 508 base pair deletion causes impaired
posttranslational processing(improper folding and
glycosylation) of CFTR.
o Abnormal protein is targetd for protasomal degradation,
preventing it from reaching to cell surface.
Mycobacterium TB
o Streptomycin(amino glycoside) resistance
o Works by inhibiting 30s subunit
o Alter structure of bacterial ribosomal proteins
IGA Nephropathy is MCC of GN.
o Painless hematuria after URI.
o Mesangial IgA deposit.
Constrictive Pericarditis
o Thickened pericardium

o Limiting ventricular expansion during diastolic filling

o Increase JVD, Kussmaul sign, pulsus paradoxus, pericardial
knock.
During exercise, increase CO2 production
o Increased PCO2 of mixed enous blood
o Hemeostatic mechanisms maintain arterial blood gas level
Transmural inflammation
o Edema and fibrosis
o Interstinal lumen narrowing.
o Causes ulcers, lead to fistula.
Phosphoribosyl Pyrophosphate synthetase is responsible for
production of activated ribose for de novo synthesis.
o Mutation here will cause increased purine production
o Result in hyperuricemia and gout.
BPH
o A1 antagonist work within days to weeks, work on dynamic
component of bladder outlet obstruction
o 5 Alpha Reductase Inhibitors(dutasteride, finasteride)
inhibit conversion of testosterone to dihydro and address
fixed component of bladder outlet obstruction. Reduce
prostate volume.
After a pancreatectomy, all enzymes are normally secreted.
o D-xylose does not get affected by the enzymes because it
is a monosaccharide.
Calcium stones have hypercalciruia, but have normocalcemia
due to intact regulation of serum calcium levels by vitamin D and
PTH.
VIPoma result in watery diarrhea, hypokalemia, achlorhydia
syndrome.
o Somatostatin inhibits release of VIP.
Eye adduction is done by CN3, which enters through the Superior
orbital fissure.
o CN6, 4, superior ophthalmic vein also enter here.
Stable angina, patient is given nitrates
o Nitrates venodilate, decrease preload(decrease LV end
diastolic volume and pressure), reduce afterload. Results in
decreased Myocardial O2 demand, relieves angina
symptoms.
In Asthmatic patients, only leukotrienes and acetylcholine
produce bronchospasm thats reeleived by pharmacologic
agents.
o Using montelukast or zafirlukast can control asthma by
increasing airway caliber and reducing mucosal
inflammation.

o Inhaled ipratropium is the MM3 antimuscuranic.

Carbon tetrachloride causes free radical injury.
o Happens through lipid peroxidation.
o Can culminate in hepatocyte necrosis.
Gallbladder hypomotility
o Gallbladder absorbs water from bile, hypomotility causes
bile concentration, which promotes bile precipitation and
accumulation of viscous biliary sludge that obstructs bile
duct.
o Sludge formation is aprecursor to stone formation.