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BRS Clinicals
Clinical questions
133
Health Care
Professional
11/08/2008

Additional Health Care Flashcards

 


 

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Term
Hereditary Hemochromatosis (HH)
Definition
- missense mutations in HFE gene (C282Y mutation)
-disorder of iron metabolism that results in cirrhosis, diabetes, skin pigmentation and heart failure
Term
Duchene muscular dystrophy
Definition
X-linked, due to frameshift mutation in dystrophin protein leading to no functional protein
-patients have proximal muscle weakness, with death from cardiac or respiratory failure
Term
Polymyosistis
Definition
-characterized by arthralgias and proximal muscle weakening
-anti-Jo-1 antibodies found in these patients
Term
Diptheria toxin
Definition
ADP-ribosylation of EF-2, inhibiting translocation in eukaryotes
Term
Neuroblastoma
Definition
gene amplification of N-myc gene
Term
Ricin
Definition
plant toxin that inactivates the 60S subunit of the ribosome
Term
I-cell Disease
Definition
-due to lack of lysosomal enzymes
-Man-6-P is not added to lysosomal enzymes and they are secreted
_defect in GlcNAc phosphotransferse
- dwarfism, grotesque face, joint defects, distended abdomen, mental retardation
Term
Grey baby Sydrome
Definition
babies' increased ability to conjugate glucuronic acid onto drugs such as chloramphenicol can result in this sydrom
Term
Leukocyte adhesion deficiency (LAD) II
Definition
deficiency to glycocylate ligands for cell surface selectins which mediate immune cell migration
-patients are prone to recurrent life-threatening infections
Term
Cystic Fibrosis
Definition
mutation of CFTR Cl- membrane transporter causes viscous secretions of the respiratory tract with recurrent life-threatening pulmonary infections
Term
Marfin syndrome
Definition
-mutation in the microfibril "Fibrillin - 1" with is found in ECM.
- patients present with excessively long extremities and fingers, arachnodactyly and predisposition to dissecting aortic aneurysms and valvular diseae
Term
Creutzfeldt-Jakob disease
Definition
transmission of a proteinaceous agent that is capable of altering the normal helical arrangement of prion protein and replacing them with beta pleated shees
Term
Marie-Tooth disease
Definition
neuromuscular diease
-mutations in hsp's
Term
alpha-antitrypsin (AAT) deficiency
Definition
AKA:serum trypsin inhibitor (serpin), protects tissues from elastase
-results in misfoldeed protein that gets trapped within the cell
-most commonly a point mutation
-manifests with cirrhosis and emphysema
-cigarette smoke can lead to oxidation of the enzyme decreasing its activity
Term
Huntington's Disease
Definition
-expansion of polyglutamine repeats in huntington protein
Term
Alzheimer's Disease
Definition
amyloidosis of beta amyloid
Term
Multiple Myeloma
Definition
Amyloidosis of Ig light chain, causing renal and heart failure
Term
Chediak-Higashi Syndrom
Definition
defect in ability to transfer enzymes from lysosomes to phagocytic vesicles
-have recurrent infections
Term
Osteogenesis Imperfecta
Definition
defect in synthesis of type I collagen
-distinctive blue sclera
Term
Hereditary spherocytosis
Definition
-defective spectrin, causing anemia and splenomegaly
Term
Familial Hypertrophic cardiomyopathy
Definition
myosin defect; enlargement of the heart, causes sudden death in young athletes
Term
Alport syndrome
Definition
defect in collagen
-X-linked characterized by renal failure, nerve deafness and cataracts
Term
Ehlers Danlos
Definition
-defect in collagen
-VI: defect in lysyl hydroxylase
-hyperextensible skin
Term
Thyroid dysgenesis/hypothyroidism
Definition
-most common cause of hypothyroidism, lowering BMR
Term
Lactase deficiency
Definition
-lactose is not digested at normal rate and accumulates in the guy where it is metabolized by bacteria
-bloating, abdominal cramps and watery diarrhea result
Term
Steatorrhea
Definition
-occurs when excess lipids are excreted into the feces due to lipid malabsorption from impaired lipolysis, micelle or chylomicron formation or transport
Term
Nontropical sprue (adult celiac disease)
Definition
-reaction to gluten causes damage the intestinal epithelium
-malabsorption
Term
Achlorhydria
Definition
-lack of ability to produce HCL
-deficiences in protein digestion and absorption
Term
Congenital neutropenia
Definition
deficincy in elastase
Term
COPD
Definition
Development can be contributed by untowardly actions of elastase in the lung
Term
Cystinuria
Definition
-transport of cysteine is defective -cystine can crystallize and for kidney stones
Term
Hartnup's diease
Definition

transport of neutral amino acids is defective, resulting in deficiencies of essential amino acids since they are not absorbed in diet

-can lead to niacin deficiency

Term
Elevated GGT
Definition
-biliary obstructions
-pancreatic cancer
-alcohol induced liver disease
Term
Hereditary deficiency of Glut-1
Definition
results in decrease glucose in the CSF, causing seizures in infancy and developmental delay
Term
Triosphospahte Isomerase deficiency
Definition
neonatal onset hemolytic anemia and neurologic involvement
children have cardiomyopathy
Term
Maturity onset diabetes of the young
Definition
-autosomal dominant
-mutations in hexokinase gene cause nonprogessive hyperflycemia
Term
Type VII Glycogen Storage disease
Definition
-PFK-1 deficiency
-inefficient use of glucose by RBC and muscle causing hemolytic anemia and muscle cramping
Term
Malonate
Definition
blocks succinate dehydrogenase
Term
Arsenic Poisoning
Definition
-inhibits a subunit of PDHC and causing impaired OX PHOS
Term
PDHC deficiency
Definition
-neurodegenerative disorder
-mild forms exhibit ataxia and mild psychomotor delay related to lactate buildup
Term
Fluoroacetate poison
Definition
Rat poison that inhibits aconitase by reacting with oxaloacetate to from fluorocitrate
Term
Fatal Infantile mitochondrial myopathy
Definition
decrease activity of mtDNA encoded respiratroy chain complexes
-patients have linver failure and neurologic abnormatlities, hypoglycemia
Term
Rotenone
Definition
a fish poison that complexes with NADH dehydrogenase, causing NADH to accumulate
Term
Amytal
Definition
a barbituate sedative that blokes complex 1
Term
MELAS
Definition
-Mitochodrial Encephalopathy, Lactic Acidosis, and Stroke
-Mutatations in complex 1
Term
Antimycin
Definition
blocks passage of electrons through complex III
Term
LHON
Definition
Leber's Hereditary Optic Neuropathy
-point mutations in Cytochrome reductase gene
Term
Kearns-Sayre Syndrome
Definition
mutations in complex II
-opthalmoplegia, pigmentary retinopathy, cardiac conduction defects
Term
Leigh's diesase
Definition
lactic acidemia, developmental delay, extraocular palsies, fatal by age 2
-usually mutation in cytochrome oxidase
Term
Cyanide and CO poisoning
Definition
combine with cytochrome oxidase
Term
2-4 Dinitrophenol
Definition
an ionophore that uncouple e- transport and ATP production
Term
Oligomycin
Definition
-binds to the stalk of the ATP synthase
-it is an uncoupler
Term
Atractyloside
Definition
inhibits ATP/ADP transport
Term
Chronic granulomatous disease
Definition
-deficiency in NADPH oxidase leading to serious recurrent bacterial infections
Term
Carbon Tetrachloride
Definition
cyp50 converts it to CCL3- which causes lipid peroxidation and hepatocellular necrosis
-dry cleaning agent
Term
Amyoptrophic Lateral sclerosis or Lou Gehrig's disease
Definition
mutations in intracellular SOD
-progressive ascending paralysis and eventual death from respiratory failure
Term
type 0 glycogen storage disease
Definition
deficiency glycogen synthase
-fasting hypoflycemia with muscle cramping
Term
type 0 glycogen storage disease
Definition
deficiency glycogen synthase
-fasting hypoflycemia with muscle cramping
Term
Andersen disease
Definition
-type IV GD
-deficiency of glycogen branching enzyme
-failure to thrive, cirrhosis, death by age 5
Term
Hers disease
Definition
defect in liver phosphorylase (typically deficiency of the protein)
-enlargement of the liver
Term
McArdle's disease
Definition
-muscle phosphorylase deficiency
-exercise induced cramps and pain
Term
Cori disease
Definition
-deficiency of debranching enzyme
-hepatomegaly, hypoglycemia during fasting, myopathy
Term
Pompe disease
Definition
-lysosomal storage diease with accumulation of glycogen within the lysosome
Term
Type Ix GSD
Definition
-deficiency of phosphorylase kinase
-hepatomegaly, growth retardation, delayed motor development, increased blood lipis
Term
Von Gierke disease
Definition
type I glycogens storage disease, deficiency of glucose 6 phosphatase
-severe hypoglycemia, seizures, brain damage, hepatomegaly, growth retardation
Term
I-cell disease
Definition
defect in addition of mannose-6P to lysosomal enxymes
-skeletal abnormalities, joint impairment, etc
Term
fanconi-Bickel syndrome
Definition
deficiency of hepatic GLUT-2 transporter, effects are similar to patients with vonGeirkes
Term
chylous ascites
Definition
-extravasation of milky chyle into the peritoneal cavity of the abdomen
-occurs in conditions such as abdominal surgery, abdominal trauma and cancers
Term
Primary carnitine deficiency
Definition
deficiency in the plasma membrane carnitine transporter leading to urinary wasting of carnitine
-
Term
Jamaican vomiting syndrome
Definition
-sudden onset of vomiting, abdominal discomfort and hypoglycemia caused by nonmetabolizable carnitine
Term
MCAD
Definition
medium chain acyl coA dehydrogenase deficiency
-manifests with hypoglycemia due to fasting because FA are not oxidized for energy
Term
Zellweger Syndrome
Definition
accumulation of VLC FA b/c peroxisome is not properly formed
Term
Adrenoleukodystrophy
Definition
VLCFA accumulate in the brain because of inability to transport into peroxisomes
Term
Type I lipidemia
Definition
-deficiency of LDL receptors
Term
type IIa hyperlipidemia
Definition
-block in LDL receptor transport
-autosomal dominant
Term
type II b hyperlipidemia
Definition
-LDL receptor transport block (partial)
Term
type III hyperlipidemia
Definition
-mutated LDL receptor
Term
Type IV hyperlipidemia
Definition
-only one with normal cholesterol
Term
Tangier disease
Definition
-disease of cholesterol transport causing low HDL and enlarged liver and spleen
-cholesterol cannot properly exit the cell to bind apo A
Term
Respiratory distress Syndrome
Definition
due to deficiency of surfactant
-dipalmitoyl phosphatidyl choline is the primary phospholipid in surfactant
Term
Niemann-Pick
Definition
-deficiency in sphingomyelinase
-mental retardation, spasticity, seizures and ataxia
-autosomal recessive
Term
Fabry disease
Definition
-deficiency in alpha-galactosidase A
-acroparesthesia, hypohidrosis
Term
Krabbe disease
Definition
-beta galactosidase deficiency
-hypertonia, hypereflexia, decerebrate posturing
Term
Guacher diease
Definition
-glucocerebrosidase
-hepatosplenomegaly, thrombocytopenia
-autosomal recessive
Term
Tay Sachs
Definition
-deficiency in hexosiminidase A
-neurodegeneration, developmental delay
-autosomal recessive
Term
3 beta hydroxylase deficiency
Definition
-decreased production of aldosterone, cortisol and androgens
-male infants manifest with ambigious genetalia
Term
17 alhpa hydroxylase deficiency
Definition
decrease production of cortisol and androgens and increase aldosterone
-lack of secondary sexual characteristics puberty
Term
deficiency of CPS I
Definition
-inability for NH3 to be metabolized by urea cycle
-can cause brain damage coma or death
Term
OTC deficiency
Definition
X-linked trait
Term
Arginnosuccinate synthetase deficiency
Definition
-elevated levels of citrulline
Term
Type I primary oxluria
Definition
results from absence of transaminase that causes renal failure due to excess oxalate in the kidney
Term
Maple Syrup Urine Disease
Definition
-enzyme complex that decarboxylates the branched chain amino acids is defective
-urine has odor, mental retardation and poor myelination can occur
Term
PKU
Definition
-defects in phenylalanine hydroxylase or tetrahydrobiopterin synthesis
-phe is converted to phenylketones causing musty urine and mental retardation
Term
Alcaptonuria
Definition
-homogentisic acid accumulates b/c defect in homogentisate oxidase
-can cause degenerative arthritis
Term
Acute lymphocytic leukemia
Definition
-malignant cells are unable to produce asparagine
Term
Isovaleric acidemia
Definition
-defective degredation of leucine causing neuromuscular irritability and mental retardation
Term
Acetaminophen overdose
Definition
-as glutathione stores dwindle, the patient moves from malaise and vomiting to jaundice, encephalopathy and death
-N-Acetylcystein is a medication that replenishes levels of GSH during toxicity
Term
Carcinoid tumors
Definition
overproduce serotonin and metastasize to liver
Term
Pellegra
Definition
-lack of niacin
-Dermatitis, diarrhea, dementia and death
-niacin can be used to treat hyperlipoproteinemia by inhibiting lipolysis in adipose and VLDL and LDL rpoduction
Term
Pheochromocytoma
Definition
patients overproduce adrenally synthesized catocholamines and have inrease VMA
Term
MERRF
Definition
Myoclonic Epilepsy with Ragged Red FIbers, mutation in Lys for mitochondria tRNA
Term
MELAS
Definition
-mutation in Leu for mito tRNA
Term
LHON
Definition
Leber's Hereditary Optic Neuropathy - antibodies to defective complex I proteins
Term
hereditary orotic aciduria
Definition
-orotic acid is excreted in the urine because UMP synthase is defective
Term
Androgen Insensitivity Syndrome
Definition
-mutations in the steroid receptor for androgens
-x-linked disease resulting in lack of masculinization of genetalia
Term
methemoglobinemias
Definition
fe is oxidizied to +3 ferric states
Term
Thalassemia
Definition
decrease of absence of one of the hemoglobin chains
-autosomal recessive
Term
alpha thalassemia
Definition
-having 2 function genes: anemia (%2 of blacks)
-having 1 functional gene: severe anemia, HbH present (B4)
-having 0 is lethal - Hb Bart
Term
beta thalassemia
Definition
-heterozygous minor has little or no effect
-homozygous: (major) "Cooley's anemia); severe anemia, expression of some HbF, shortened life expectancy
Term
Sickle Cell Hb
Definition
Glu->Val subsitution
-homozygotes: anemia, painful infarcts, aplastic crisis, sequestration crisis, infections, renal failure, visceral damage
-heterozygotes: may have anemia; protected from malaria
Term
Fragile X
Definition
Trinucleotide repeat disease (CGG) in 5'UTR causing mental retardation
Term
Frederich's ataxia
Definition
Trinucleotide repeat (GAA) in intron causing ataxia
Term
Xeroderma pigmentosum
Definition
-rare, autosomal dominant
-mutation in nucleotide excision repair genes
Term
Cockayne syndrome
Definition
-mutation in CSA or CSB causing defective DNA repair
Term
hereditary nonpolyposis colon cancer
Definition
mutation in MutS and MutL
Term
Nijmegen breakage syndrome
Definition
- NBS1 gene is mutated (non-homologous end joining) characterized by chromosome instability and increased cancer
Term
Cushing syndrome
Definition
caused by excessive production of cortisol by an adrenal tumor
Term
Cushing Disease
Definition
hypercortisolemia caused by excessive secretion of ACTH by pituitary tumor
Term
Addison disease
Definition
-ACTH is responsible for the increased pigmentation observed in patients
loss of adrenocortical steroids, causing loss of Na and water in urine
Term
beta globin gene splicing
Definition
the most common cause of beta-thalassemia are defects in mRNA splicing of the gene
Term
Hereditary Hemochromatosis
Definition
-genetic disease associated with mutations in the HFE gene
-mutations are used to screen for this disorder of iron metabolism which results in cirrhosis, diabetes, skin pigmentation and heart failure
Term
Duchenne Muscular Dystrophy
Definition
-x-linked
-due to frameshift mutation in dystrophin protein leading to nonfunctional protein
-muscle weakness and cardiac or respiratory failure
Term
Diptheria Toxin
Definition
ADP-ribosylates EF-2, thus inhibiting translocation in eukaryotes
Term
Neuroblastoma
Definition
-gene amplification causes over 300 copies of N-myc gene
Term
von Recklinghausen (neurofibromatosis-1)
Definition
-cafe-au-lait spots, tumors of peripheral nerve sheath and 7th cranial nerve
Term
Follicular lymphoma
Definition
caused by chromosomal translocation which causes accumulation of malignant B cells that express high levels of bcl-2
Term
Acute Myelogenous Leukemia
Definition
mutant retinoic acid receptor that blocks white blood cell differentiation
Term
Hunter Syndrome & Hurler Syndrome
Definition
-accumulates heparin sulfate
-x-linked deficiency (hunter) causing mental retardation
Term
Acute Intermittent porphyria
Definition
-defect in uroporphyrinogen synthase I
-elevated porphobilinogen and dALA
-does not lead to photosensitivity
Term
Congenital erythropoeitic porphyria
Definition
-defect in urophorphyrinogen synthetase III
Term
Hereditary porphyria
Definition
-defect in coproporphyrinogen
Term
porphyriacutanea tarda
Definition
uroporphyrinogen decarboxylase deficiency
-causes accumulation of uroporphyrin
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