つかれました。
手抜き。
ほぼほぼ。
1.Angiotensin II, atrial natriuretic peptide(ANP), insulin, and vasopressin signal through cell-surface receptors.
Aldosterone binds its receptor in the cytosol, after which the receptor-hormone complex transits to the nucleus.
アルドステロンはcytosolの受容体に結合→核へ
2.IL-8 attracts neutrophils
IL-8は好中球遊走
3.高地に適応するのに2,3-bisphosphoglycerateが増える→oxygen-hemoglobin dissociation curve右へ。
4.Hepatitis A virus (HAV) はpicornavirus。
5.TB is caused by Mycobacterium tuberculosis, an acid-fast bacillus.
Part of its virulence is related to a major glycolipid in the mycobacterial cell wall called “cord factor,” which creates a microscopically clumped appearance of the cells, called a “serpentine cord.” Cord factor activates macrophages and induces the release of tumor necrosis factor-α, contributing to the formation of caseating granulomas.
結核：TNFαを分泌させ乾酪性壊死を形成。
6.Protein Aは黄ブ菌。
7.M proteinはS.pyogenes。
8.Lipid Aはグラム陰性菌の外膜にあるendotoxin。炎症、septic shockに関与。
9.Central DI is associated with low urine osmolality, hypernatremia (when patients can’t drink water), and positive free water clearance.
下垂体腫瘍摘出→ADH低下→Central DI→Free water clearance of 2.5 L per day
10.【Invasive ductal carcinoma】
組織)atypical glandular cells that form irregular tubules within a dense connective tissue (desmoplastic) stroma.
Metalloproteinases allow degradation of the basement membrane
→progression from carcinoma in situ to invasive carcinoma.
11.Subepithelial electron dense deposits are seen in other forms of glomerular disease, such as membranous glomerulonephritis
上皮下蓄積→膜性腎症。
12.Mixed cryoglobulinemiaはsmall vessel vasculitis。抗原抗体物質の蓄積antigen-antibody depositionによる。 腎組織でmembranoproliferative glomerulonephritis with glomerular immune complex deposition and subendothelial electron dense deposits.
内皮下
13.【Postpartum blues】：within 2 to 3 days of delivery,
depressive symptoms such as dysphoria, insomnia, fatigue, and impaired concentration.
程度はmildでself-limiting。
・resolving within 2 weeks of onset.
2,3日で症状が出現し、数日でピーク、2週間以内に改善。
14.【Postpartum psychosis】：within 1 month of delivery.
a maniclike episode of agitation, expansive or irritable mood, delusions, hallucinations, and severe lack of sleep for several nights.
マニック！
15.【Postpartum hypothyroidism】
associated with depression 2 to 6 months after having a baby, but this patient has no other symptoms of hypothyroidism (eg, cold intolerance, constipation, or dry skin).
2-6ヶ月のうつ、その他甲状腺症状なし。
産後の精神症状は発症時期で比較的鑑別可能。
16.Pooling of abnormal circulating RBCs in the spleen
←the mechanism of splenic sequestration crisis seen in sickle cell disease.
abnormal RBCs are trapped in the spleen leading to acute splenomegaly and an acute drop in hemoglobin level.
異常RBCが脾臓でトラップ。
17.Risk factors for cataracts in children
・metabolic disorders (classic galactosemia, galactokinase deficiency)
・chromosomal disorders (trisomy 13, 18, 21)
・ToRCHeS infections (eg, rubella)
・genetic disorders (Marfan syndrome, Alport syndrome, myotonic dystrophy, and NF 2).
18.【Maple syrup urine disease】
results in an increase of leucine levels due to deficiency of the branched-chain alpha-ketoacid dehydrogenase complex.
αケト酸。
19.【Hereditary hemochromatosis】
・autosomal-recessive disorder leading to hepatic cirrhosis.
・a disorder of the HFE gene→excess absorption of iron, which leads to elevated saturation of transferrin with iron.
ヘモクロマトーシスは鉄吸収過剰。
20.Purkinje cells transmit cerebellar cortical activity to the deep cerebellar nuclei.
Purkinje cells are inhibitory neurons and use GABA as its neurotransmitter.
21.Acetylcholine and glutamate are excitatory, not inhibitory, neurotransmitters.
Dopamine and glycine are neurotransmitters that can be inhibitory but are not found in the cerebellum.
アセチルコリンとグルタミンは興奮を伝える。
ドーパミンとグリシンは抑制だか小脳には存在しない。
22.Microtubule assembly/disassembly
→ビンクリスチンとパクリタキセル
23.Replicative infectious forms describe the elementary and reticulate bodies of Chlamydia trachomatis, which is not visible on Gram stain.
クラミジアはGram染色じゃみえんよ。
24.A helical shape with two cell membranes and flagella trapped between them is a characteristic of Treponema pallidum. It is visualized with dark-field microscopy, not Gram stain.
梅毒はhelical shape。Gram染色ではみえん。
25.
Neisseria meningitidisはpolysaccharide capsuleをもち、meningitisを引き起こす。
26.Tinea corporis
治療はtopical or oral antifungal therapy（ketoconazole)
ケトコナゾールはfungal cytochrome P-450を阻害することでfungal membrane sterols合成阻害。
27.Transduction involves DNA transfer from infection of a virion packaged with DNA (a so-called lytic phage) from another bacterial cell.
Transformationは周りの環境から新しいDNAを取り込むプロセス。
Translocationは同じ染色体内あるいは別の染色体から別の場所へ移動。
ざっくり。
28.へその緒がなかなか取れない→LAD
LAD type I：decreased expression or function of CD18。
29.Nephrogenic DIはADH resistance(principal cells of the cortical collecting duct).
腎性尿崩症はADHに反応しない。集合管の主細胞が原因。
30.リウマチ熱はGASによる。GASの毒素はM蛋白。
M蛋白の抗体は自己抗原にも反応する→molecular mimicryという。
特に心臓とCNSに蛋白がM蛋白抗体が作用するため雑音やSydenham choreaを引き起こす。
31.Hb Barts diseaseが最もsevere formな α-thalassemia・
all four α-globin genesがないパターン。
→inability to make HbA1, A2, and F.
RBCsは4つのγ-chainsで構成さてる。
●This disease is fatal in utero.
32.HbHはthree of the four α-globin genesがないパターン。
→↓α-chain production、abnormal Hb called HbHが増える。
33.Pericarditisはcoxsackievirus
コクサッキーはRNA virusでPicornaviridae family。
34.
Positive, single-stranded, helical RNA virus→Coronaviridae
コロナはヘリカル。
35.HDV is a deficient virus that utilizes hepatitis B envelope proteins (HBsAg) to release its progeny via a process called complementation. HDV requires coinfection with HBV to infect a host
HDVはHBVがいないと生きていけない。
36.Cannabis intoxication is characterized by altered mental status, increased appetite, conjunctival injection, and slurred speech.
大麻はオランダで勧められた。吸ってはいない。だらっとなる。
37.Antihistamine intoxication presents with findings consistent with anticholinergic toxicity, including elevated pulse, respirations, and blood pressure; mydriasis; decreased bowel sounds; dry skin; and dry mouth.
抗ヒスタミン中毒は抗コリン中毒と似ている。
テンション上がる方のやつ。
38.Amphetamine intoxication presents with findings consistent with sympathomimetic toxicity, including elevated vital signs, mydriasis, decreased bowel signs, wet skin (perspiration), and agitated mood.
アンフェタミンは交感神経上がる系。むーどもあじてーと。
39.Decreased inhibitory neurotransmitter release by toxins such as Tetanospasmin (produced by Clostridium tetani) and decreased stimulatory neurotransmitter release by toxins such as botulinum toxin (produced by Clostridium botulinum) would cause spastic or flaccid paralysis, respectively.
40.Finasteride inhibits 5α-reductase to decrease the synthesis of DHT and can be used for the treatment of benign prostatic hyperplasia.
ふぃなす。
41.Borrelia burgdorferiはspirocheteでLyme diseaseの原因となる。
Ixodes tickが媒介。
42.Central DIはdeficient secretion of ADH
ADHはparaventricular and supraoptic nuclei of the hypothalamusで産生。
→travels down the axon through the infundibulum to the posterior pituitary gland, where it is stored until released into the blood.
43.Diabetic retinopathy is a common cause of vision loss in patients with diabetes mellitus and presents with the slow onset of blurry vision, floaters, dark spots, and loss of night vision.
夜盲...?
44.NF2：increased risk for developing cataracts, causing patients to present with blurry vision.
両側腫瘍2個→NF2
45.Acetaminophen overdose has caused acute liver failure.
Acetaminophen is known to cause centrilobular, or zone 3, necrosis.
46.Macrovesicular steatosis can be caused by alcohol abuse, nonalcoholic fatty liver disease, diabetes mellitus, and, in rare cases, use of drugs such as corticosteroids.
副腎皮質ホルモンでも脂肪肝になるよ。
47.Intermediate zone lesions are seen in patients with yellow fever caused by a RNA virus.
イエローフィーバー。
48.Pulmonary fibrosis is a serious adverse event associated with several pharmaceutical agents, including bleomycin, amiodarone, busulfan, and melphalan.
肺腺腫症をきたす薬剤にメルファラン。
49.Lymphoid aggregates with germinal centers and Hurthle cells (seen in Hashimoto thyroiditis) and tall, crowded follicular epithelial cells with scalloped colloids (seen in Graves disease) would be associated with smooth, nontender goiters.
50.肺炎でaerobic bacillary pathogen
→Legionnaires’ disease, caused by L pneumophila and transmitted via inhalation of water droplets from contaminated water systems, is associated with respiratory symptoms, hyponatremia, and gastrointestinal symptoms.
P aeruginosa usually occurs in hospitalized patients or in immunocompromised community patients. It is an aerobic bacillus but not a common cause of hyponatremia or musculoskeletal symptoms.
緑膿菌とレジオネラとの鑑別はどちらもaerobic bacillusだか、緑膿菌は低ナトや筋骨格系の症状はきたさない。
