2015.04.11 (2) Flashcards
Common causes of bacterial meningitis
Streptococcus pneumoniae (Gram + cocci - lancet shaped diplococci)
Listeria monocytogenes (Gram + rods)
Neisseria meningitidis (Gram - cocci - bean shaped diplococci)
Escheria coli (Gram - rods)
Haemophilus influenzae (Gram - coccobacilli)
Histone H1
located outside of the nucleosome core and helps to package nucleosomes into more compact structures by binding and linking DNA between adjacent nucleosomes.
Androgenetic alopecia
Most common cause of hair loss in both males and females.
Polygenic inheritance (influenced by multiple genes) with variable penetrance.
Otitis media causing organisms
most common:
Streptococcus pneumoniae
Haemophilus influenzae
Moraxella
Recurrent infections with these organisms indicate humoral immunodeficiency.
Severe Combined Immune Deficiency (SCID)
Recurrent infections caused by bacteria, viruses, fungi, and opportunistic pathogens as well as failure to thrive and chronic diarrhea within the first year of life.
Profound hypoplasia of both B-lymphocyte and T-lymphocyte tissue.
Lymphopenia and hypogammaglobulinemia.
Pneumocystis and chronic mucocutaneous candidiasis
associated with underlying T-cell deficiency
Charcot-Bouchard aneurysms
Associated witih hypertension
Located: Basal ganglia, cerebellum, thalamus, pons
Size < 1mm
Result of rupture: intracerebral hemorrhage
Symptoms: progressive neurologic deficits, headache
Saccular (berry) aneurysms
Associated with ADPKD, Ehlers-Danlos syndrome, hypertension.
Located: Circle of Willis
Size: variable, 2-23mm
Result: subarachnoid hemorrage
Symptoms: sudden severe headache, focal neurologic deficits uncommon
Vitamin A Toxicity
Subdivided into:
Acute - NV, vertigo, blurred vision.
Chronic - alopecia, dry skin, hyperlipidemia, hepatotoxicity, hepatosplenomegaly, and visual difficulties
Teratogenic - microcephaly, cardiac anomalies, fetal death
Intracranial hypertension, skin changes, hepatosplenomegaly
Niacin Deficiency
3 D’s of pellagra: dementia, dermatitis, diarrhea
Where is body’s satiety center located?
Ventromedial nucleus of the hypothalamus.
Neurons here detect glucose elevations and signal satiety.
Lesions cause hyperphagia and obesity.
Rage/savage behavior sometimes noted.
Most commonly caused by tumor invasion.
Lateral Nuclei of the hypothalamus
signals hunger.
lesions would cause one to lose desire to eat
Suprachiasmatic nuclei
above the optic chiasm
receive visual input from the retina via the optic tract.
regulate circadian rhythms by relaying light information to other hypothalamic nuclei and to the pineal gland
Anterior hypothalamic nuclei
when body temperature rises, it signals cooling by stimulating the parasympathetic nervous system to produce vasodilation and sweating.
Lesions cause uncontrolled hyperthermia and death.
Posterior hypothalamic nuclei
regulate heat conversation and heat production when the body is cold.
Standard error
SD/sqrt(n)
Account for variability due to sampling and helps estimate the true mean of the underlying population
Red blood cell fragments, burr cells, and helmet cells
Associated with either microangiopathic hemolytic anemia or mechanical red cell destruction.
In patients with prosthetic valves, RBCs are exposed to excessive shear and turbulence in the circulation, causing damage from mechanical trauma.
Obstructive Sleep Apnea Syndrome
recurrent nocturnal upper airway obstruction and apnea (daytime sleepiness, poor energy).
Each nocturnal episode of reduced ventilation causes transiet hypercapnea and hypoxemia resulting in reflexive systemic and pulmonary vasoconstriction as well as sympathetic cardiac stimuolation.
Can result in pulmonary hypertension and right heart failure.
Left ventricular systolic failure
Usually due to to myocardial ischemia and causes heart failure, which decreases ejection fraction and increases end-systolic ventricular volume.
S3 sound (ventricular gallop) is audible from blood rushing into a partially filled ventricle or stiff ventricle.
S3 best heard with bell (low frequency sounds) in left lateral decubitus position with the patient exhaling to bring the heart closer to the chest wall.
Straining phase of Valsalva manuever (bearing down against closed glottis)
Differentiates between causes of systolic murmur in the left heart.
Decrease venous return to the heart, reducing left ventricular volume and blood pressure.
Murmurs associated with MVP and hypertrophic cardiomyopathy become more audible.
Murmurs associated with aortic stenosis are less audible.
Supine hypotension syndrome (Aortocaval compression syndrome)
Hypotension, pallor, sweating, nausea, and dizziness that occurs when a pregnant woman lies supine. Symptoms resolve when standing or left lateral decubitus position.
Due to gravid uterus compressing and obstructing IVC (reduces venous return, which lowers CO and leads to hypotension).
Alcoholics and pulmonary infections
Alcoholics are at increased risk for aspiration pneumonia because alcohol intoxication impairs the gag and cough reflexes. Poor oral hygiene, impaired phagocytic and/or bactericidal action of alveolar macrophages.
Pulmonary infections usually polymicrobial: anaerboic (Bacteriodes, Prevotella, Fusobacterium, Peptostreptococcus) admixed with aerobic (Streptococcus, Klebsiella).
Clindamycin covers most of these organisms - antibiotic of choice for treating lung abscesses.
Anemia associated with neurologic abnormalities
Vitamin B12 deficiency .
Hematological manifestions are megaloblastic anemia and pancytopenia.
Cofactor for methylmalonyl CoA mutase (methylmalonyl CoA into succinyl CoA). Leads to elevated methylmalonic acid which result in myelin synthesis abnormalities (subacute, combined degeneration of posterior and lateral spinal columns).
Loss of position and vibration sensation, ataxia, and spastic paresis.
Decrease progression of diabetic nephropathy
ACE-I class of drug with Angiotensin receptor blockers
