Cardio Q1- didactic

what is a macule

small and flat

what is a patch

large and flat

what is a papule

small and raised

what is a plaque

large and raised

seborrheic keratosis (SK) characteristics

benign epidermal growth, “stuck-on” appearance, also known as “wisdom spot/barnacle”

when would you refer for a seborrheic keratosis skin lesion

if rapidly growing, symptomatic- pain, bleeding, itching, burning

skin tag characteristics

benign epidermal growth, common on eyelids/neck/axillae, can become infarcted and necrose

skin tags are associated w

age, pregnancy, diabetes, obesity/metabolic syndrome

acanthosis nigricans characteristic

benign “velvety” and darkened skin

acanthosis nigricans is seen usually where on the body

on neck and armpits

acanthosis nigricans is more associated w

obesity, insulin resistance/metabolic syndrome

acanthosis nigricans is more commonly seen in what populations

black and indigenous populations

cherry angioma characteristics

benign vascular proliferation (thin-walled dilatated capillaries)

cherry angioma is more associated w

hormone status (e.g. pregnancy)

cherry angioma is seen usually where on the body

face, neck, trunk, extremities

what is diascopy

applying a glass slide onto the lesion w gentle but even pressure and watching the lesion flatten, should see blanching

bite fibroma characteristics

chronic trauma (usually biting), painless and asymptomatic, may require biopsy for dx

mucocele characteristics

rupture of minor salivary gland- mucin collection in soft tissue, swells and pops repeatedly, may fibrose over time, may require biopsy for dx

fordyce spots characteristics

ectopic sebaceous glands, no tx, asymptomatic, any age affected

fordyce spots are seen where in the body

vermillion border, buccal mucosa

xanthelasma

type of plane xanthoma, 50% have underlying hyperlipidemia

what is hyperlipidemia

high levels of lipids (fats) in the blood

xanthelasma is more common in…

women (3x more than men)

solar lentigo characteristics

benign epidermal growth, marker of ultraviolet radiation exposure

types of skin cancer

basal cell carcinoma, squamous cell carcinoma, melanoma

what is the most common type of skin cancer and least concerning

basal cell carcinoma

risk factors for basal cell carcinoma

UV exposure, radiation, light skin, age

actinic keratosis characteristics

precancerous lesion, marker of actinic damage (and skin cancer risk), sandpaper texture, flakes off and comes back

actinic cheilitis characteristics

usually lower lip (AK of lip), can see dryness, cracking, white color

is actinic keratosis or actinic cheilitis at higher risk of transformation to SCC

cheilitis > keratosis

squamous cell carcinoma in-situ is also referred to as

bowen’s disease

squamous cell carcinoma in-situ appearance characteristics

full thickness epidermal involvement w/o invasion into dermis

what is the second most common skin cancer and has a low risk of metastasis

squamous cell carcinoma

risk factors for squamous cell carcinoma

UV, radiation, transplant, tobacco use, light skin, age, chronic non-healing wounds

which skin cancer is the most aggressive of the common skin cancers and has a higher risk of metastasis

melanoma

risk factors for melanoma

fair skin, red hair, >50-100 moles, >5 atypical moles, UV exposure, family history

ABCDE stands for

Asymmetry, Borders, Color, Diameter, Evolving

bone mass is dynamic, what does this mean

it changes according to loading

bone remodeling allows for…

bone adaption to load and repair of damage

what is the cellular “renovation” team

osteo-cytes, clasts, blasts

what are osteocytes

start/stimulate bone formation/resorption dynamic

what are osteoclasts

resorb bone

what are osteoblasts

build bone

what is the osteocyte network

osteocytes extend plasma membrane projections through canaliculi where neighboring osteocytes are connected by gap junxs that allow sharing of intracellular material and signaling molecule

what is the purpose of the osteocyte network

so mechanical forces experiences by one osteocyte can produce a response in all of its neighbor

what are the phases of remodeling bone

activation→ resorption → reversal → formation → quiescence

what cell is responsible to initiate remodeling by inc RANKL secretion

osteocytes

activation phase of bone remodeling

osteocytes (and osteoblasts) secrete RANKL that stimulates clasts differentiation and osteoprotegerin (OPG) that will supress osteoclast differentiation

what is osteopetrosis- “marble bone disease”

a disorder of impaired osteoclast activation

what are osteoclasts doing during the resorption stage of bone remodeling

mature clasts form tight attachments on the bone surface to form resorptive space

what enzymes are used in the resorption stage of bone remodeling, that osteoclasts use to produce and pump acid into the resorption space

carbonic anhydrase, vacuolar ATPase

what components are released into the cellular space during resorption of bone remodeling

acidic pH and secreted proteases digest the mineral and protein components of bone and these are released

reversal stage of bone remodeling

osteoclasts are resorbing and secreting factors that stimulate -blast differentiation/activity

the reversal stage of bone remodeling is marked by…

reduction in number of -clasts and recruitment of -blast precursors

formation stage of bone remodeling

-blasts produce a (primarily) type I collagen matrix- osteoid- and secrete -blast stimulating factors that embed within the matrix for future remodeling

in bone formation, what does mineralization look like starting from a mesenchymal stem cell

preosteoblast → osteoblast → osteoid osteoblast → mineralizing osteocyte → osteocyte

quiescence stage of bone remodeling

-cytes of newly formed bone secrete variety of -clasts and -blast inhibitory factors to suppress resorption and formation

what is the major -blast inhibitor

sclerostin

as -blasts become -cytes, their expression of sclerostin __________ (inc/dec)

inc

the bone will remain __________ until more stress or damage is detected

quiescent

a disease caused by loss of sclerostin

sclerosteosis

sclerosteosis is characterized by

global progressive inc in bone density, possible hearing, sight, or smell due to CN compression, sudden death due to brain stem compression

sclerosteosis is what mode of inheritance

autosomal recessive inheritance pattern

when you zoom into muscle, you will see

muscle fibers

when you zoom into muscle fibers, you see

myofibrils

when you zoom into myofibrils, you will see

sarcomeres

when you zoom into a sarcomere, you see

G/F actin filaments

when you zoom into actin filaments, you see

myosin filaments

myofibril sarcomeres are made up of

thick and thin filaments interdigitated

what drives filament sliding of the sarcomere

interactions between the thick and thin filaments

thick filaments are made up of

myosin heads

what primarily makes up the thin filaments

actin

lever-arm rotation is coupled to…

ATP hydrolysis

what cycle drives all of muscle contraction in all life

Myosin’s chemo-mechanical cycle

what is rigor mortis

when muscles get stiff and cannot be manipulated

why does rigor mortis happen

myosin gets stuck in the myosin-actin state “waiting” for next ATP to come

What neurotransmitter triggers muscle contraction

acetylcholine

what role does calcium play in muscle contraction

when ca channels are open, ca “bathes” sarcomeres and binds to the thin filaments

What does the sarcoplasmic reticulum store

calcium

what are the two divisions or the circulatory system

cardiovascular and lymphatic

what does the cardiovascular system include

blood vessels and heart, plus the blood they carry

what does the lymphatic system include

lymph vessels plus the lymph they carry

the vessels of the circulatory system include

arteries, arterioles, capillaries, venules, and viens

what is an artery

conducting/distributing vessel

what is an arteriole

resistance vessel- major determinant of systemic bp

what is a capillary

gas/nutrient exchange vessel

what is a venule

exchange vessel- inc permeability during inflammation

what is a vein

conducting/reservoir vessel

is there a higher pressure in the arterial or venous system

arterial

most of the time, there is more blood on the venous or arterial side

venous

blood pressure will start to decrease when going from arteries to _________ and will continue to decrease until you pump the blood back out of the heart

arterioles

tissue perfusion

in the capillaries, maintains homeostasis of the tissue fluid by exchanging stuff (e.g. water, nutrients, gases, metabolites, ions, hormones, etc)

there are more __________ than any other blood vessel in the body

capillaries

the flow rate is lowest at _________ bc…

capillary beds; give time for exchanges

a neurovascular bundle contains…

an artery, vein, lymph vessel, nerve

what are the three main capillary types

continuous, fenestrated, discontinuous

continuous capillary characteristics

most common type, cells are tightly packed

fenestrated capillary type characteristics

rapid exchange between tissue and blood- have thinner spots within cell for shorter exchange

discontinuous capillary type characteristics

sinusoids- only found in 3 places in the body: bone marrow, liver, spleen

capillary type

continuous