3/16/16 Flashcards
Three types of professional APCs; they can activate T-lymphocytes…1) MHC recognition and 2) CD28/B7 interaction
Dendritic cells
Macrophages
B-lymphocytes
Seminoma (most common testicular neoplasm ages 15-35)
- Painless and radiosensitive
- Large cells in lobules with watery cytoplasm (fried egg appearance)
Precocious puberty in boys, gynecomastia, Reinke crystals, non-germ cell tumor
Leydig cell tumors
Defect in lysosomal emptying of phagocytic cells due to microtubular dysfunction; Autosomal Recessive, Recurrent streptococcal and staphylococcal infections
Chediak-Higashi disease
Multiple cold (non-inflamed) skin abscesses and high levels of IgE due to reduced production of interferon gamma by helper T-cells→Failure of neutrophils to respond to chemotactic stimuli (not activated)
Job syndrome
Number one cause of viral gastroenteritis and fatal diarrhea in children
Rotavirus (Reovirus family): naked, linear-segmented ds-RNA
Down Syndrome associations:
Congenital heart defects: especially endocardial cushion defects
Acute lymphocytic leukemia (“we ALL fall Down”
Alzheimer changes in brain after 35
Duodenal atresia
What is used to prevent the nephrotoxic effects of cyclosporine?
Mannitol diuresis
Progressive gait and truncal ataxia with onset between ages 1-4 years
Defective DNA repair enzymes (ATM kinase)
Associated with IgA deficiency
Cerebellar problems (ataxia)
Spider angiomas (telangiectasias)
Ataxia-telangiectasia
B-blockers decrease the oxygen demand on the heart how?
Decrease HR, contractility, afterload (increased diastolic filing)
Decreased CO and BP
Drug that can be used in both ectopic pregnancy and gestational choriocarcinoma
Methotrexate
Belligerence Impulsiveness Fever Psychomotor agitation Vertical and horizontal nystagmus Tachycardia Homicidality Psychosis and delirium
PCP intoxication
Alpha-galactosidase A enzyme deficient
Ceramide trihexoside→ lactosyl cerebroside
Fabry’s Disease
Lysosomal storage disease in which patients cannot degrade sulfatides
Deficient in Arylsulfatase A (sulfatides to galactocerebroside)
Cerebroside sulfate in both neuronal and non-neuronal tissues
Metachromatic granules on histology
Widespread loss of myelination in CNS and peripheral nerves
Metachromatic leukodystrophy (AR lysosomal storage disease)
Beta-Galactocerbrosidase enzyme deficient
Galactocerebroside→Cerebroside
Krabbe’s disease
Tay-Sachs disease enzyme deficiency
Hexosaminidase A
Ganglioside M2→ Ganglioside M3
PCP pupils and eyes
Normal or small pupils (enlarged with coke or amphetamine toxicity)
Vertical and horizontal nystagmus
Niemann-Pick Disease enzyme deficiency
Sphingomyelinase
Sphingomyelin→ Cerebroside
CF patient sweat content and poop content = LOSING volume without losing bicarb = Contraction alkalosis (on a hot sweaty day)
High Cl-
Low bicarb (stool is low in bicarb too)
This is similar to people on excessive diuretics→lose bicarbonate-free fluid on excessive diuretics
Ataxia-telangiectasia mutation?
ATM kinase (double-stranded DNA break repair enzyme)
Susceptible to X-ray damage
At risk for Leukemia and Lymphoma
Acute intermittent porphyria (disease of defective heme synthesis)
Defect in porphobilinogen deaminase
Abdominal pain, red wine-colored urine, neuropathy and psychological disturbances
T-helper 1 cells produce __________________ to stimulate macrophage activity and have antiviral and antitumor effects
INF-gamma
Systemic nonspecific symptoms: fever, rash, bone swelling.
Proliferation of histiocytes on blood smear
Histiocytosis X
Nondisjunction with microcephaly, microphthalmia, polydatyly, hypotonia and heart defects
Trisomy 13 (Patau’s syndrome)
Competitively inhibits GABA-A receptors (inotropic/ ligand-gated ion channels; post –synaptically located)
Flumazenil (Benzo overdose)
GABA-A receptor works how?
Major inhibitory neurotransmitter in CNS
Upon activation→ Cl- enters the cell→Hyperpolarization and subsequent inhibition of new action potentials
GABA-B receptor AGONIST Muscle relaxant (can exacerbate absence seizures so no longer used for epilepsy)
Baclofen
Bicuculline and strychnine→convulsion that can lead to death
Antagonists of glycine receptor
Cause of death usually in NMS (neuroleptic malignant syndrome)
Acute renal failure
20% mortality rate
Serotonin storm
SSRIs, opioids and others
Symptoms begin within minutes
Dilated pupils, myoclonus, hyperthermia, high BP, tachycardia, and sometimes even muscle rigidity
Tardive dyskinesia
Common ADR of neuroleptics
Stereotyped facial or other repetitive movements
Start a few months or longer after starting neuroleptics
Often cannot be stopped; even after stopping drug
Bacteriostatic antibiotics that bind to 23S rRNA of 50S ribosomal subunit
Macrolides (azithromycin and erythromycin)
Loading dose (LD) formula
LD= (desired plasma concentration) X (volume distribution/bioavailability)
Seizure drug that can cause folic acid deficiency→megaloblastic anemia
Phenytoin
Aspirin can produce a combined metabolic acidosis/ respiratory alkalosis; an aspirin overdose can be detected how?
Positive ferric chloride test
Postmenopausal women have decreased estrogen (thus increased bone resorption)→ osteoporosis. Decreased estrogen levels also decreases negative feedback on anterior pituitary and hypothalamus resulting in …
ELEVATED LH, FSH, and GnRH
Extrapyramidal adverse effects of antipsychotics (timeline of 4)
Acute dystonia = 4 hours
Akathisia = 4 days
Bradykinesia = 4 weeks
Tardive dyskinesia = 4 months
After childhood immunizations for tetanus, a booster shot should be given every ____ years to prevent C.tetani- related trismus and muscle spasms following trauma. What is trismus?
10 years
Trismus = lockjaw
Tetany=sustained contraction of skeletal muscles
Increased risk for ASYMPTOMATIC UTIs
Diabetics
