1.acute hemolytic transfusion：type II hypersensitivity reaction
IgG antibodies bind to donor RBCs.
不適合輸血での溶血はHSRⅡ。ドナーの赤血球に対する抗体。
2.Iliopsoas tendinopathy
repetitive hip flexion causes an achy pain worse with activity and a popping noise with hip extension and internal rotation.
腸腰筋腱炎は股関節の屈伸運動で起こる。
ハードルで股関節に違和感のケース。
・greater trochanter of the femur：the insertion points of the gluteus medius, gluteus minimus, obturator internus, and other muscles.
大腿骨大転子部に付着する筋。
3.p53：tumor suppressor protein that can arrest progression from G1 to S phase. Inhibition of p53→uncontrolled cell growth.
p53はがん抑制遺伝子。G1からS期の制御に関わる。
異常があれば細胞周期が進む。
4.Deletion of 11p13：Wilms tumors and aniridia as part of the WAGR complex (Wilms tumor, Aniridia, Genital anomalies, developmental delays).
WAGR。
5.Patau syndrome：trisomy 13
症状：holoprosencephaly, cleft lip/palate, microphthalmia, cutis aplasia, intellectual disability, polydactyly, congenital heart disease, and rocker-bottom feet.
13番。先天性皮膚欠損症。
6.A Zenker diverticulum
症状はdysphagia, obstruction, gurgling, aspiration, foul breath, and a neck mass. It typically occurs in older adults.
成人の病気です。
7.HIV diagnosis
An initial enzyme-linked immunosorbent assay (ELISA) detects the presence of antibodies, followed by a confirmatory HIV-1/2 antigen/antibody immunoassay if the initial ELISA results are positive.
Further differentiation is then performed using an HIV-1/HIV-2 antibody differentiation immunoassay to determine HIV-1 or HIV-2 status.
ELISAで抗体の有無確認→HIV-1/2 antigen/antibody immunoassay
スクリーニングで出しますが...
8.C3a and C5a are mediators of anaphylaxis.
C3aとC5aがアナフィラキシー。
フローチャートを思い出す。
9.Bicornuate uterus：incomplete fusion of the paramesonephric ducts.
paramesonephric ducts fuse to form a single uterus, cervix, and superior two-thirds of the vagina.
双角子宮は中腎傍管の形成不全。
10.Fibrates：agonists at the PPAR-α nuclear transcription factor
→ upregulation of lipoprotein lipase, thereby increasing VLDL catabolism and triglyceride clearance.
リポプロテインリパーゼ。
11.Nitrosamines：found in cured meats.
→esophageal, stomach cancer and HCC.
ニトロソアミンは生肉に含まれている→食道癌、胃癌、肝臓癌...
生肉はたべるものではないですね。
12.HIV薬
・Zidovudine：HIV prophylaxis and decreased vertical transmission in pregnancy.
貧血の副作用をきたすのはZidovudine。垂直感染減らす。
・Efavirenz：non-nucleoside reverse transcriptase inhibitor (NNRTI).
Adverse effects of NNRTIs：hepatotoxicity and a rash and CNS symptoms(vivid dreams).
エファビレンツは鮮やか夢をみると。
・Ritonavir：protease inhibitor.
Adverse effects of ritonavir：hyperglycemia, GI intolerance (nausea, diarrhea), lipodystrophy, neuropathy, and hematuria,
リトナビルはプロテアーゼ阻害薬。副作用に血尿。
13.Mycobacterial infection is associated with silicosis.
This disorder is associated with foundry work, sandblasting mines, and masonry.
鋳造、鉱山、ブロック、レンガ、コンクリートが関連あり。
14.Pancoast tumors：damage the second-order preganglionic sympathetic neurons that pass through the inferior cervical or stellate ganglion and ascend to synapse in the superior cervical ganglion.
パンコースト腫瘍は2次ニューロンにダメージ。
15.IVH usually occurs in premature infants or those of low birth weight.
症状はseizure, flaccid weakness, hypoventilation, and cranial nerve abnormalities.
出生後すぐの脳室内出血。
32週以前の低体重はIVHのリスク。
16.Skeletal abnormalities, coarse facial features, corneal clouding, and psychomotor delay
→I-cell disease(inherited lysosomal storage disease.)：caused by dysfunction of UDP-N-acetylglucosaminyl-1-phosphotransferase→loss of the mannose-6-phosphate tag that would normally traffic lysosomal enzymes to lysosomes.
I-cell diseaseはUDP~酵素の欠損によりマンノースの標識が障害→ライソゾームへの輸送が障害。
→ライソゾーム蓄積。
通常であれば細胞輸送はゴルジ装置の役割。マンノースの標識の修正はゴルジ装置で行われ、蛋白をライソゾームに送る。
17.Chlamydia trachomatis can cause pneumonia during infancy.
トラコマティスは子供の肺炎の原因になる。
18.Nocardia asteroides is a gram-positive bacterium that can cause pneumonia and also pulmonary abscesses.
ノカルジアは肺炎にもなるが、膿瘍を形成する。
19.Prevalence looks at all current cases
existing cases / total number of people (at a specific point in time)
プリバレンス有病率は全人口のうちの罹患数。
20.Both TCAs and SNRI (venlafaxine and duloxetine)：preventing presynaptic reuptake of norepinephrine and serotonin.
デュロキセチンとアミトリプチンの作用は似てる。ノルアドとセロトニンの再吸収阻害。
・Clozapine：blocking postsynaptic dopamine and 5-HT receptors.
a second-generation, or atypical, antipsychotic。
schizophrenia or schizoaffective disorderの第2選択薬。
・Mirtazapine：a2-antagonist
increased release of NE and 5-HT.
It also potently antagonizes histamine H1 receptors.
ミルタザピンはH1ブロッカーの作用あり。
・Selegiline：selective monoamine oxidase (MAO) B inhibitor
for Parkinson disease.
MAO inhibitors：catecholamines↑
Tranylcypromine：nonselective MAO inhibitor
→increasing the concentrations of NE, 5-HT, and dopamine.
21.Job syndrom：Production of interferon-γ by helper T cells is reduced.
症状）
・eczematous and pruritic rash on the face and trunk
・multiple “cold” (noninflamed) skin abscesses
・high levels of IgE
・abnormal facial features (broad nose and protruding forehead)
DNA repair enzyme defects：ataxia-telangiectasia →associated with IgA deficiency, ataxia, abnormal eye movements, and telangiectasias.
22.Vitamin D deficiency：hypophosphatemia by decreasing intestinal absorption of phosphate and increasing urinary phosphate excretion.
ビタミンD欠乏は低リン。吸収低下と排出増加。
低リンの症状は重症でなければ症状はでない。
Symptoms）fatigue, muscle weakness, appetite loss, and more severely, confusion, irritability, bone pain, and fractures.
・phenytoin, carbamazepine, cyclophosphamide, dexamethasone, rifampicin内服でビタミンDの代謝亢進で欠乏になる。
23.HPV strains 16 and 18→cervical carcinoma
by inhibiting the p53 and Rb tumor suppressors with genes E6 and E7.
深さ：CIN 1(<1/3), CIN 2 (1/3 to 2/3), CIN 3 (over 2/3), and invasive carcinoma (extending below or above the epithelial surface).
深さでCIN判定。
24.Papanicolaou (Pap) test：cervical cancer screening
to detect dysplastic changes caused by human papillomavirus (HPV) infection.
パパニコローは頚癌のスクリーニング。HPV感染による異型性変化を検出。
25.Bacterial vaginosisの治療
→metronidazole：an antimicrobial and antiprotozoal agent
free radicals damage DNA within bacterial or protozoal cells.
細菌性膣炎メトロニダゾール。
フリーラジカルでDNAにダメージ。
26.β-Adrenergic receptor antagonists reduce Gs-protein activation。
reducing the amount of cAMP and activation of protein kinase A (PKA)
→β-receptor antagonists decrease the Ca2+ currents within the AV node.
βブロッカーは房室結節の伝導を抑制。
27.An abnormally large cranium, small jaw, low-set ears, and clenched hands with overlapping fingers are common signs of trisomy 18 (Edwards syndrome).
clenched handはEdwards18
28.Achondroplasia usually manifests with short stature and decreased limb length.
・FGFR3 gene mutation
29.Iodine deficiency：goiter in inland developing countries.
Goiterの鑑別にHashimoto thyroiditis or Graves disease.
Iodine deficiencyは抗体陰性.
30.Suppression：mature ego defense defined by consciously withholding negative thoughts or feelings.
ネガティブな話題を避けて対応。
大学の推薦がダメになって、その話題を避ける。
31.WAGR syndrome refers to the combination of Wilms tumor, aniridia, genitourinary anomalies, and intellectual disability.
von Hippel-Lindau syndrome：a rare inherited disorder with a mean age of diagnosis of 29 years.
VHLは大人になってから診断される。遅い。
32.The most common toxicity of niacin：flushing, which can be reduced by pretreatment with aspirin.
ナイアシンのよるフラッシュの副作用にはアスピリンが効く。へー。
NSAIDs, especially aspirin, reduce the production of prostaglandins, and a pretreatment with aspirin before starting niacin therapy can reduce flushing significantly.
事前に飲むこともあるのか。日本でもそうなのか？
33.Damage in the region of the superior division of the MCA
→Broca (expressive) aphasia
運動性失語
A stroke causing a receptive aphasia would be located in Wernicke area in the temporal lobe.
障害部位はinferior division of the middle cerebral artery (MCA).
感覚性失語。
34.Alphavirus may cause encephalitis but is unlikely to cause bilateral pulmonary edema.
West Nile virus typically causes fever, gastrointestinal symptoms, and headache but is unlikely to cause bilateral pulmonary edema.
35.Macrolides：binding to the 23S-ribosomal RNA of the 50S-ribosomal subunit, thereby inhibiting protein synthesis by blocking translocation.
マクロライド系は50Sに結合しtranslocationをブロックし蛋白合成阻害。
36.Fluoroquinolones：inhibiting topoisomerase II (DNA gyrase) and topoisomerase IV.
キノロンはトポイソメラーゼを阻害。
37.Common causes of ARDS
sepsis, pneumonia, aspiration, trauma, acute pancreatitis, and blood transfusion (>15 units).
膵炎で入院、翌日に呼吸困難のケース
膵炎はARDSのリスク。
15単位以上の輸血もARDSのリスク。
38.LABA stimulation of the Gs-coupled β2-receptor
→activation of adenylyl cyclase→a rise in cAMP and activation of protein kinase A (PKA).
PKA phosphorylates a site on myosin light chain (MLC) kinase that prevents calcium/calmodulin binding, leading to an inactivation of MLC kinase, an enzyme that phosphorylates MLC in the presence of adenosine triphosphate.
MLC phosphorylation leads to cross-bridge formation between the myosin heads and actin filaments, and hence, smooth muscle contraction.
LABA-induced inactivation of MLC kinase thus causes relaxation of smooth muscles in the bronchi as well as in the blood vessels.
LABAの機序。
LABAはMLCミオシン軽鎖のリン酸化阻害→カルシウム結合を阻害→平滑筋弛緩
ミオシン軽鎖のリン酸化はミオシンとアクチンを結合→平滑筋収縮
39.A sodium-dependent symporter in the distal convoluted tubule accounts for absorption of sodium and chloride, not glucose.
Serum glucose of up to 200 mg/dL can be reabsorbed in the proximal tubule by the sodium-dependent glucose symporters (primarily SGLT2).
近位尿細管で再吸収できるのは血糖200までー。尿糖でてたらPGは高い。
40.PCP intoxication
aggression, psychomotor agitation, elevated temperature, tachycardia, hypertension, and nystagmus.
瞳孔は正常。
41.Alcohol, morphine, and phenobarbital→CNS depression.
アルコール、モルヒネ、フェノバルビタールは下がる。
42.Amphetamines and cocaine：pupillary dilation, euphoria, and hallucinations.
アンフェタミンとコカインは瞳孔散大、幻覚、多幸感
43.IEの起因菌・歯科治療歴確認。
・Staphylococci (S aureus)
・viridans streptococci (eg, S mutans, S sanguinis, S oralis, and S mitis)
・enterococci
44.S agalactiae：causing illness in newborns(sepsis, pneumonia, and meningitis).
GBSは新生児の髄膜炎、肺炎を起こす。
45.Struvite stones：seen in patients with urinary infection and staghorn calculi.
Struvite stones(ストルバイト; リン酸マグネシウムアンモニウム)：caused by infection with urease(＋) microorganisms (eg, Proteus, Klebsiella, and S saprophyticus).
ウレアーゼ陽性→プロテウス、クレブシエラ、サプロフィティカス
46.NADPH is an electron carrier used in steroid synthesis as a supply of reducing equivalents.
It is generated by glucose-6-phosphate dehydrogenase in the oxidative portion of the pentose phosphate pathway. Although there are multiple electron carriers in the cell, enzymes are highly specific as to which cofactor they can use.
47.Hemoglobin exists in two forms: the T form ＆ the R form.
The T form＠peripheral tissues：lower oxygen affinity・deoxygenated (low oxygen) form
ヘモグロビンはT formとR formがある。
Tは低酸素。
48.Sildenafil：PDE-5 inhibitors prevent metabolism of cGMP→ vasodilation and maintenance of an erection.
49.Azathioprine：antimetabolite precursor of 6-mercaptopurine.
It acts by interfering with purine nucleotide synthesis.
SLEで腎症。ステロイド抵抗性→6-MP
50.Hepatitis B core antibody：2–3 months after exposure.
It is the only marker that can still be detected at 5 months, during the "window period," that can differentiate between chronic and acute infection
ウインドウでみられるのはHBc抗体。
暴露から2,3ヶ月で症状。5ヶ月続く。
