atherosclerosisextracellular matrix/collagen is laid down by migrated smooth muscle cells

from media layer

- produces the fibrous cap of mature atheroma
if depressed patientwho responds to SSRI within 2 wks! likely to be bipolar
- antidepressants take 4-8 wks to set in
!plasma insulin lvlsincreasing time to reach peak conc
- aspart/lispro/glulisine < regular < NPH < detemir < glargine
vasoarteriolar dilation=reflexual sym activity= tachy, contractility, increased renin activity
!RNA pol I=rRNA (28S, 5.8S rRNAs)
RNA pol II=mRNA, snRNA (splicing), miRNA
RNA pol III=tRNA, 5S rRNA of 60S ribosomal unit
6-MP
- via HGPRT=active metabolites for purine syn inhibition
- via TPMT or XO=inactive
coronary sinus returns venous heart blood to the RA
- myocardial O2 extraction is maximally high even at rest! highest O2 extraction of all the
organs
primary active transport=ATPase transporters that break down ATP to move cmpd against its
conc gradient
shaken baby syndrome
- poor cervical tone; enlarged subarachnoid spaces=higher brain water content
- shaking=tearing of the bridging veins=subdural hemorrhages
S3 heart sound
- ventricular enlargement
- low freq sound, heard with bell over apex in LLD position at end of expiration (makes sound
more loud by decreasing lung volume and bringing heart closer to chest wall)
- venodilators, diuretics, Valsalva= decreased intensity
PPV increases as disease prevalence in the population increases
- NPV increases as prevalence decrease
!hereditary angioedema
- defect in C1 esterase inhibitor
- C1esterase I usually inhibits C1(esterase) and kallikrein (which converts plasminogen!
plasmin , HMWK! bradykinin)
- edema is due to bradykinin, C3a, C5a
- do not give ACEi