NEW REVIEW

• 11 hydroxylase inhibitor ->
• increase in 11-B-deoxycortisol (no ACTH inhibiton)
• -> increased ACTH ->
• high levels of 11 deoxycortisol in serum
• high levels of 17 hydroxy-corticosteroid in urine

• Adrenal medulla tumor in children
• HVA elevated in urine
• No episodic hypertension like pheochromocytoma
• Over expression of N-myc oncogene -> rapid tumor progression
• Neurofilament stain of Homer Wright Pseudorosettes

Decrease production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2

CLINICAL: Addisons, inflammation, immune suppression, asthma, keloids

TOXICITY: Cushings, buffalo hump, truncal obesity, muscle wasting, thin skin, easy bruisability, osteoporosis, adrenocortical atrophy, peptic ulcers, diabetes

• Increases lactic acid production
• Decreases gluconeogenesis

• Contraindiacted in Renal failure
• Also not for patients in heptic failure

Connects integrin to the basement membrane and extracellular matrix with collagen and laminin

• Lead lines on gingivae(burtons lines) and on epiphyses of long bones on x-ray
• Encephalopathy and erythrocyte basophilic stippling
• Abdominal colic and sideroblastic anemia
• Wrist and foot drop

• TX: Dimercaprol and EDTA
• Succimer for kids

ALL: Children, TdT +

CLL: >60yoa, smudge cells, warm antibody hemolytic anemia

Hairy cell leukemia: TRAP +

AML: Auer rods(peroxidase +, -> DIC), M3(all-trans retinoic acid)

CML: Philadelphia chromosome (t[9:22], bcr-abl), low LAP

• Ab to spliceosomal snRNPs are made
• Therefore there is no splicing of hnRNA
• therefore RNA cannot be processed and thus can not be transported out of the nucleus

Rifampin inhibits DNA dependent RNA polmerase

Tetracycline binds 30S subunit preventing attachment of aminoacyl-tRNA

• dec a-fetoprotein
• inc B-hCG
• dec estriol
• inc inhibin A

• Progressive ataxia of all 4 limbs (cerebellar dysfunction/ dorsal column)
• Hypertrophic cardiomyopathy (arrhythmia/ CHF)
• Skeletal abnormality - kyphoscoliosis
• DM (10%)

• Cofactor for homocysteine methyltransferase (transfers CH3 groups as methylcobalamin) Homocysteine + N-methyl THF -> Methionine and THF
• Methylmalonyl-CoA mutase (methylmalonyl-CoA -> succinyl-CoA)

• Deficiency:
• macrocytic megaloblastic anemia, hypersegmented PMNS
• neuro (paresthesias, subacute combined degeneration) because of abnormal myelin

hemolytic anemia

• Degeneration of spinocerebellar tract, dorsal column of spinal cord, and peripheral nerve
• - ataxia, dysarthria, and loss of both position and vibration sense

lipoic acid

• Findings:
• vomiting, rice water stools, garlic breath

RBC, leukocytes, kidney, medulla, lens, testes, and cornea

• Increased chylomicrons
• Elevated TG, cholesterol

LPL deficiency or altered apolipoprotein C-II. Causes pancreatitis, hepatosplenomegaly, and eruptive/pruritic xanthomas (no increased risk for atherosclerosis

a1 - inc vascular smooth muscle contraction, inc pupillary dilator muscle contraction, inc intestinal and bladder sphincter contraction

M1- CNS, enteric nervous system

M3- Inc exocrine gland secretion, inc gut peristalsis, inc bladder contraction, bronchonstriction, inc pupillary sphincter muscle contraction, ciliary muscle contraction

H1- inc nasal and bronchial mucus production, contraction of bronchioles, pruritis and pain

V1- inc vascular smooth muscle contraction

• Metronidazole
• procarbazime
• 1st generation sulfonylureas
• cephalosporin

• Stain with silver stain
• Grows on charcoal yeast extract culture with iron and cysteine
• Detected clinically by presence of antigen in urine

Transmitted via aerosol, no person to person

Causes Legionnaires disease, Pontiac fever, and interstitial pneumonia

TX: erythromycin (macrolide)

• Microangiopathic hemolytic anemia
• acute renal failure
• thrombocytopenia

EHEC - shiga-like toxin -> endothelium swelling and narrowing -> symptoms

• Coxsackie A
• Rocky mountain spotted fever (R. ricketsii)
• Syphillis

you drive CARS using your palms and soles

• Coccidioidomycosis
• SW states -> pneumonia and meningitis
• can disseminate to bone and skin

• -> Cryptococcal meningitis
• Heavily encapsulated yeast transmitted by respiration  

Founc in soil and pigeon droppings

• Sabourauds agar, India ink stain, latex agglutination
• Soap bubble lesion in brain

• retrovirus
• togavirus
• flavivirus
• coronavirus
• hepevirus
• calicivirus
• picornavirus

I went to a RETRO TOGA party, where I drank FLAVored CORONA and ate HIPPY CALIfornia PICKLES

All RNA are ss except reoviridae and rotavirus

• Influenza virus
• parainfluenza virus
• RSV
• measles virus
• mumps virus
• rubella virus
• rabies virus
• HTLV
• HIV

• Produced at apical ectodermal ridge(thickened ectoderm at distal end of each developing limb)
• Necessary for proper organization along dorsal-ventral axis
• mediates ectodermal function

• Muscle
• bone
• connective tissue
• serous lining of body cavities
• spleen
• cardiovascular structures
• lymphatics
• blood
• bladder
• urethra
• vagina
• eustachiantube
• kidneys
• adrenal cortex
• skin dermis
• testes / ovaries

Chiari II - cerebellar tonsillar herniation through foramen magnum with aqueductal stenosis and hydrocephaly. Presents with syringomyelia, thoracolumbar myelomeningocele.

Dandy-Walker- large posterior fossa; absent cerebellar vermis with cystic enlargement of 4th ventricle. Can lead to hydrocephalus and spina bifida

• Tuberculosis
• Fungal (histoplasmosis, blastomycosis)
• Syphillis gummas
• Leprosy
• Cat scratch fever
• Sarcoidosis (noncaseating)
• Crohns disease
• Berylliosis
• Listeria
• Foreign bodies
• Wegners granulomatous
• Chronic granulomatous disease

• abl - tyrosine kinase- CML
• c-myc- transcription factor- Burkitt's lymphoma
• bcl-2- antiapoptotic- Follicular/ undiff lymphoma
• erb-B2 tyrosine kinase- breast ovarian and gastric carcinomas
• ras - GTPase - Colon carcinoma
• L-myc- Transcription factor - lung tumor (SCC)
• N-myc - transcription factor- neuroblastoma
• ret- tyrsine kinase - MEN
• c-kit - cytokine receptor- gastrointestinal stromal tumor

• Multiple sclerosis
• hay fever
• SLE
• Goodpasture's

• CD40
• MHC II
• B7

• Macrolides (erythromycin)
• Antimalarials (chloroquine/ mephaquine)
• Haloperidol
• Risperidone
• Methadone
• Protease inhibitors
• Antiarrhythmics (Class IA)
• K channel blockers

• Tetralogy of Fallot
• Transposition of the great vessels

• Dopamine antagonists (antipsychotics)
• estrogens (OCPs, pregnancy)
• TRH

They decrease afterload -> increase in foward stroke volume and a decrease in regurgitant flow.

• Flushing
• vasodilation
• insulin resistance
• hyperuricemia

Right sided murmurs

• Thyroid hormones
• retinoids
• PPAR
• Fatty acid

• Block degradation of bradykinin and substance P
• -> lung irritation

• decreased Na and Cl-
• increased K+
• metabolic acidosis (dec HCO3-)

From the ventricles in response to hypertrophy via volume overload

Abnormal neural crest cell migration

• B1 only:
• decreased cAMP in heart (dec contractility and HR)
• decreased cAMP in JG cells

• DNA methylation via methyltransferase
• same enzyme used in the SAM reaction

• a1- via IP3 increase in the arteries
• B1 increase cAMP in the heart
• a 2- dec cAMP -> dec NEP and insulin

Statins and fibrates(gemfibrozil)

Vancomycin with Rifampin and/or gentamicin

Very low heart rate (negative chronotropy)

insoluble pigment consisting of lipid polymers and protein complexed phospholipid) that come from free radical injury and lipid peroxidation