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Describe the structure of cilia.
- Cilia is composed of 2 central microtubules, surrounded by 9 microtubule doublets.
- Each microtuble doublet is connected to the adjacent doublet by dyenin arms.
- Dyenin arms contain the dyenin ATPase that generates energy for the dyenin arms to slide past each other, producing ciliary movement.

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What complications can arise from Kartagener syndrome?
- Male and female infertility- immotile sperm and dysfunctional fallopian tube cilia
- ↑risk of ectopic pregnancy
- Bronchiectasis- enlargement of lung airways
- Recurrent sinusitis
- Situs inversus (e.g dextrocardia)- Cardiac point of maximal impulse is on the RIGHT
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What causes Hyper IgM syndrome?
Defective CD40L/ CD154 on CD4+ T cell → B cell cant undergo class switching from IgM
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What causes a persistent truncus arteriosus?
Caused by the abnormal neural crest cell migration through the truncus arteriosus and bulbus cordis to separate the aorta and pulmonary artery.
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What causes Transposition of the great vessels?
Failure of the aorticopulmonary septum to spiral due to abnormal migration of neural crest cells.
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What causes Tetraology of Fallot?
- Abnormal migration of neural crest cells through the truncus arteriosus and bulbus cordis to separate the aorta and pulmonary artery.
- Results in anterior displacement of the infundibular septum.

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Which heart defects are caused by the abnormal migration of neural crest cells?
- Tetralogy of Fallot
- Transposition of the great vessels
- Truncus arteriosus
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What does an endocardial cushion defect results in?
- Failure of the atria and ventricles to separate.
- Defect in atrioventricular septum.

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Where are thyroid hormone receptors located?
Inside the nucleus
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Describe the splitting of an Atrial Septal Defect.
- Wide, fixed spliiting of S2.
- ASD creates a left to right shunt (because of higher pressure in the left atrium).
- This results in increased blood flow through the pulmonary artery, delaying pulmonary closure.
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What causes Eisenmenger syndrome?
Uncorrected left-to-right shunt (VDS, ASD, PDA) causes such ↑ pulmonary blood flow through the pulmonary atery, which results in pathologic remodeling of the vasculature (pulmonary sclerosis).
- The hypertrophied Right ventricle occurs to compensate and the shunt becomes right-to-left.
- Causes late cyanosis, clubbing and polycythemia.
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Describe the symptoms of heroin withdrawal.
- Dilated pupils
- Piloerection
- Yawning
- Lacrimation
- Hyperactive bowel sounds/ stomach cramps
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Describe the clinical presentation of myasthenia gravis.
- Ptosis- drooping of eyelid
- Diplopia
- Eye weakness- tired eyes
- Muscle weakness worsens during course of the day
- Decreased force of muscle contraction with repetitive stimulation
- Associated with thymomma or thymic hyperplasia- presents as ANTERIOR MEDIASTINAL MASS
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Where does lymph from the head drain into?
Cervical lymph node
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Where does lymph from the esophagus drain into?
Cervical lymph node
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Where does lymph from the lungs drain to?
Hiliar lymph node
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Where does lymph from the trachea drain into?
Mediastinal lymph node
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Where does lymph from the esophagus drain to?
Mediastinal lymph node
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Where does lymph from the testes drain into?
Para-aortic lymph node
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Where does lymph from the ovaries drain into?
Para-aortic lymph node
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Where does lymph from the kidneys drain into?
Para-aortic lymph node
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Where does lymph from the uterus drain into?
Para-aortic lymph node
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Wher does the popliteal lymph node drain?
- Dorsolateral foot
- Posterior calf

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Where does the axillary lymph node drain?
- Upper limb, breast, skin above umbilicus

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Where does the celiac lymph node drain?
- Liver, stomach, spleen, pancreas, upper duodenum

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What does the superior mesenteric lymph node drain?
- Lower duodenum, jejunum, ileum, colon to splenic flexure

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Where does the inferior mesenteric lymph node drain?
- Colon from splenic flexure to upper rectum

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Where does the internal iliac lymph node drain?
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Where does the superficial inguinal lymph node drain?
- Anal canal (below pectinate line)
- Skin below umbilicus (except popliteal territory)
- Scrotum
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Where does lymph from the scrotum drain into?
Superficial inguinal lymph node
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Where does lymph from the bladder drain into?
Internal iliac
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Where does lymph from the prostate drain into?
Internal iliac
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Where does lymph from the anal canal (above the pectinate line drain into?
Internal iliac
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Where does lymph from the anal canal (below the pectinate line) drain into?
Superficial inguinal
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Label the image below
- A- I band
- B- A band
- C- H band
- D- I band
- E- Z line
- F- M lineG- Z line
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At this region of the sacomere, myosin filaments are bound to structural proteins.
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At this region of the sacomere, actin filaments are bound to structural proteins.
D&F: Z line
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At this region of the sacomere, actin does not overlap with myosin.
A: I band
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At this region of the sacomere, myosin does not overlap with actin
C- H band
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Which bands decrease in size during contraction?
I-band and H-band
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This band extends over the entire region of the thick myosin filaments.
B- A band
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This band does not change size during contraction.
B- A band
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What is sampling bias?
- Non-random sampling of a populationA common example is that severely ill patients are the most likely to enroll in cancer trials, leading to results that are not applicable to patients with less advanced cancers.
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What is Allocation bias?
- Can result from the way treatment control groups are assembled.
- It may occur if subjects are assigned to the study groups of a clinical trial in a non-random fashion.
- For instance, in a study comparing oral NSAIDs and corticosteroid injects for the tx of osteoarthritis, obese patients may be preferentially assigned to corticosteroid group.
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What is detection bias?
- Refers to the fact that a risk factor itself may lead to extensive diagnostic investigation and increase the probability that a disease is identified.
- For instance patients who smoke may undergo increased imaging surveillance, due to their smoking status, which would detect more cases of cancer in general.
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What is Referral (admission rate) bias?
- Occurs when the case and control populations differ due to admission or referral practices.
- For instance, a study involving cancer risk factors performed at a hospital specializing in cancer research may enroll cases referred from all over the nation. However, hospitalized control subjects without cancer may come from only the local area.
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