D&D Unit 3 Flashcards
What is the range for fitzpatrick skin types?
I to VI where I is super light and VI is super dark
What are the 2 types of melanin?
Eumelanin - black/bron
Pheomelanin - yellow/red-brown
What is the melanin distribution difference between light and dark skin?
Light - melanosomes are distributed in clusters above the nucleus
Dark - melanosomes are distributed individually throughout the cytoplasm
Which skin cells synthesize vitamin D?
Keratinocytes
Which skin cells provide immunologic protection?
Langerhans cells
I think they are the macrophages
Which skin glands lubricate the skin?
Sebaceous
Which skin glands create pheromones?
Apocrine glands
What are the 2 layers of the dermis? What is their connective tissue like?
Papillary - loose connective tissue
Reticular - dense connective tissue
What is the embryonic origin of melanocytes?
Neural crest
How many keratinocytes get melanin from each melanocyte?
30
How long does epidermis renewal take?
About 28 days
What causes epidermolysis bullosa symplex?
Congenital defects in keratin filaments 5 and 14
What are the 5 layers of the epidermis?
Stratum basalis Stratum spinosum Stratum granulosum Stratum lucidum Stratum corneum
What does filagrin do?
Cross-links keratin tonofilaments
What organs in the skin sense touch? Where are they located?
Meissner’s corpuscles
Papillary layer of the dermis
What organs in the skin sense touch, vibration, and pressure? Where are they located?
Pacinian corpuscles
Reticular layer of the dermis
Where are the blood vessels for thermoregulation located?
Reticular layer of the dermis
What are the 2 types of sweat glands?
Apocrine - in axillary, pubic, perianal regions
Eccrine - everywhere else
Downward projections of epidermis are called ________________ and interdigitate with the ______________ of the dermis
What are they for?
Epdermal rete
Dermal papillae
Increase strength of adherence and surface area between epidermis and dermis
Which collagen is most prevalent in the adult dermis?
Collage I
Which collagen is most prevalent in the fetal dermis?
Collagen II
Which collagen is most prevalent in the basement membrane?
Collagen IV
Which collagen attaches the epidermis and dermis?
Collagen VII
What is the structure of collagen?
3 chains arranged in an alpha helix
Striations at 68nm intervals. These are usually Gly-Pro-Hydroxyproline
What is an important cofactor required for extracellular assembly of collagen fibrils?
Vitamin C (ascorbic acid)
How do you tell microscopically if skin is from an old person or a sun-exposed site?
Presence of solar elastosis
They are basophilic
What happens to the skin in pseudoxanthoma elasticum?
Elastic fibers become enlarged, tangled, calcified
What 2 things is ground substance made of?
Hyaluronic acid
Dermatan sulfate
They are both glycosaminoglycans
What is auspitz sign?
In psoriasis, when scales are removed, pinpoint bleeding occurs
What causes leukocytoclastic vasculitis?
Immune complexes form and precipitate in vessel walls
- > inflammation
- > palpable purpura
What is itch n medical terms?
Pruritus
Where do nerves end in the skin:?
The dermoepidermal junction
What are the afferent nerves for pruritus?
Small, unmyelinated C fibers with a slow conduction rate
What do Pacinian corpuscles resemble?
What do Meissner’s corpuscles resemble?
Onion
Pinecone
What are the 2 types of hairs?
Terminal hairs
Vellus hairs
What are the 3 areas of a hair?
Infundibulum
Isthmus (from the sebaceous duct to insertion of arector pili)
Matrical area
What embryonic structure is the follicular unit derived from?
Primitive ectodermal germ
What are the lower, middle, and upper bulges of the primitive ectodermal germ for?
Lower - attachment for arrector pili
Middle - sebaceous gland
Upper - apocrine gland
What are the 3 growth phases hair can be in?
Anagen - growth
Telogen - resting
Catagen - transition between anagen and telogen
What 2 treatments are there for androgenic alopecia?
5-alpha-reductase inhibitor (blocks conversion of testosterone to 5-dihydrotestosterone
Minoxidil
What are the 3 parts of the eccrine gland?
Coiled secretory portion
Intradermal duct
Intraepidermal portion
From deep to surface
What neurotransmitter triggers sweating?
Acetylcholine
What part of the autonomic nervous system triggers sweating (sympathetic or parasympathetic)?
Sympathetic
Where are apoeccrine glands found?
Axilla
Albnism is due to a defect in the _________ gene in the melanin production pathway
Tyrosinase
Where are 3 places we get vitamin D from?
Sun exposure
Fish/figh liver oils
Egg yolks
What causes rickets?
Vitamin D deficiency
Which layer are skin stem cells located in?
Basal cell layer (stratum basalis)
Where in the skin are hemidesmosomes found?
They attach the basal cells to the basal lamina of the dermal-epidermal junction
What is bullous pemphigoid?
Autoimmune response to hemidesmosomes, causing the dermal-epidermal junction to separate -> subepidermal blisters
Antibodies to BP230 or BP180
What is epidermolysis bullosa?
Defect in laminin 5 -> blistering
What is dystrophic epidermolysis bullosa?
Defect in collagen VII -> scarring, flexion contractures
Autosomal recessive
What is pemphigus vulgaris?
An acquired autoimmune disease with antibodies to desmoglein 1 and desmoglein 3
-> flaccid bulla, intraepidermal blisters
What is epidermolysis bullosa simplex?
Genetic defects in keratin 5 and 14
What is the breakdown product of filaggrin?
Natural moisturizing factor. It binds water to keep the skin moist
What causes icthyosis vulgaris and atopic dermatitis?
Loss-of-function filaggrin mutations -> defective skin barrier function.
There are significantly reduced levels of natural moisturizing factor, so more water loss occurs
What are Merkel cells for? Where are they?
They are important for neural development and tactile sensation
They are small cells associated with nerve endings in the epidermis
Where is stratum lucidum located? What does it do?
In thick skin
It helps reduce friction and shear forces between the stratum corneum and stratum granulosum
What is are dermatologic terms for flat things (2)?
Macule - A flat area of color change 1 cm
Patch >1 cm
What are dermatologic terms for elevated things (3)?
Papule - 1cm. Width > thickness
Nodule - >1 cm
Plaque >2 cm
What is scale?
Excess stratum corneum
Can come as flakes or plates
Color is usually white or grey
What is crust?
Dried blood, serum, or purulent exudate that forms on the skin surface
What are dermatologic terms for fluid filled things?
Vesicle- 1cm filled with blood or fluid
Bulla >1 cm
Pustule filled with pus
What are the 2 types of bullas?
Tense
Flaccid
What are dermatologic terms for pus-filled things?
Pustile - >1 cm, circumscribed elevation
What defines an ulcer?
What 3 things further classify it
A circumscribed loss of epidermis and at least upper dermis
Depth
Edge
Tissue at base
What is an eschar?
A scab!
A black, adherent, thicky, dry crust
What is a dermatologic condition that is distributed following lymphatic vessels?
Lymphangitic
What is a dermatologic condition that is distributed on palms and soles?
Palmoplantar
What is a dermatologic condition that is distributed in regions with skin-skin contact that causes friction?
Intertriginous
What is a dermatologic condition that is distributed on skin overlaying muscles that flex joints?
Flexural
What are the collagen differences between the papillary and reticular dermis?
Papillary - thin collagen bundles
REticular - thick collagen bundles
Procollagen is synthesizes within fibroblasts and extracellularly and enzymatically cleaved into ____________
Tropocollagen
What is Ehlers-Danlos syndrome? What are 4 symptoms?
A group of diseases with messed up collagen synthesis Hyperextensible skin Hyperextensible joints Fragile blood vessels Poor wound healing
What is pseudoxanthoma elasticum? What are 4 symptoms?
Mutation in MDR gene
-> calcified, brittle elastic fibers
Plucked chicken skin
Systemic hypertension
Angioid streaks in retina
Arterial rupture (particuarly in eye)
Are there genetic diseases of ground substance?
No
Does the epidermis contain vasculature?
No
What are the 2 types of skin vessels?
Superficial and deep plexi
What are the 2 main differences between type A and C nerve fibers?
A - heavily myelinated, rpid conduction
C - unmyelinated, slow-conducting
What are the 4 subtypes of type A fibers?
A-alpha - proprioception and large motor units (largest)
A-beta - touch
A-gamma - spindle organs in muscle stretch receptors
A-delta - fast-localizing initial component of pain (smallest)
Does hair form from the outside in or inside out embryologically?
Outside in
The mesenchyme induces the overlying neuroecoderm to bud downwards
What is milaria?
Prickly heat
From blocked sweat ducts (the eccrine ones)
What is anhidrotic ectodermal dysplasia?
Mutant EDA gene
Abberant eccrine development
-> decreased sweating
-> poor temperature regulation
Also get other ectoderm problems like sparse hair and abnormal teeth
What is seborrheic dermatitis a more severe form of? What 4 things is it seen in?
Dandruff that can affect scalp, face, upper torso
Parkinson’s
Head trauma
HIV
Chronic neurologic conditions like cerebral palsy
What 4 skin problems are found in diabetes?
Acanthosis nigricans
Yellow skin
Brown patches on lower legs
Foot ulcers
What is the skin like in hyperthyroidism? (2)
Smooth, warm, moist
Pretibial myxedema
What is the skin like in hypothyroidism? (5)
Dry skin Brittle nails Sparse hair Delayed wound healing Puffy madarosis (loss of lateral third of eyebrow)
What is stasis dermatitis?
Chronic venous insufficiency of lower extremities with lower extremity edema
Often seen with other things due to venous insufficiency down there
What are the differences in morphology and location of inflammation between dermatitis and cellulitis?
Dermatitis has erythematous papules and thin plaques with scale
Cellulitis is warm, tender erythematous patches or plaques
Dermatitis is in the epidermis/dermis.
Cellulitis is in the dermis and subcutaneous tissues
How do you diagnose allergic contact dermatitis?
Patch testing
What is the most frequent dermatologic allergen?
Nickel sulfate
What is dermatitis also called?
Eczema
Where are venous stasis ulcers usually? What do they look like?
On medial lower leg just above ankle.
Red with yellow fibrinous base
Borders irregularly shaped
Can be purulent f infected
What is infantile atopic dermatitis?
Dry, red, scaly areas on the cheeks that become flushed w/ cold exposure
Usually under 5 years of age
What is the most common type of contact dermatitis?
Irritant contact dermatitis
What 3 things does allergic contact dermatitis require?
Exposure of an allergen
Immune response
Development of memory T cells
3 risk factors for nckel sensitivity
Female
Young
Exposure
What 2 ointments often have sensitivity reactions?
Neomycin
Bacitracin
What is the usual time course for drug eruptions?
1-2 weeks after starting a new medication
Starts sooner if given a medication previously reacted to before
What type of immune hypersensitivity is urticaria?
Type I - mediated by IgE
What is nummular dermatitis caused by?
Excess use of soap and dry skin
What causes seborrheic dermatitis? (2)
A combination of overproduction of skin oil and irritation from yeast )malassezia furfur)
4 subtypes of psoriasis
Chronic plaque disease
Guttate
Erythroderma
Pustular psoriasis
2 comorbidities for psoriasis
Metabolic syndrome
Cardiovascular disease
How long does it take for a fingernail to grow out?
6 months
What is the diabetic rash on the shin?
Necrobiosis lipoidica
What are Janeway lesions?
Septic microemboli that cause bruises
What are osler nodes?
Raised, red legions on hands and feet
Erythematous, painful vasculitis
Found in endocarditis
What are Roth spots?
Retinal hemorrhages
How do you get strep viridans in the blood?
Teeth - usually dental cleaning
What happens in systemic scleroderma? (3)
Thickened skin (hands, mouth, esophagus, GI)
Raynaud’s
Pulmonary hypertension
What happens in lichen planus? (4)
Purple, polygonal, pruritic papules
Lace-like white lines
Mucosal lesions
Nail involvement (like white lines there)
What 3 things differentiate an expanding ulcer from a regular ulcer? How do you treat them?
Has a sharp drop-off edge
Not usually in places with bad circulation
More common in inflammatory disease
Treat with steroids, NOT antibiotics
What are 2 nail discoloration findings where the tips turn red?
over half red - renal problems
less than half - cirrhosis, congestive heart failure
What should are 6 dermatologic clues someone has cancer?
Erythema gyratum repens (whorly red marks)
Hypertrichosis languinosa acquisita (extra languo)
Tripe palms
Lesser trellat sign (explosive onset of multiple seborrheic keratoses)
Dermatomyositis
Sister Mary Joseph Node
Where on the body are drug rashes?
Trunk, not extremities
What are the pH differences between normal and pathogenic skin bacteria’s preferred environments.
Normal - acidic
Bad - neutral
What are the 2 bacteria that cause impetigo?
Beta-hemolytic streptococci -> non-bullous impetigo
Staphylococcus aureus -> both non-bullous and bullous impetigo
What is the food source for candida (2)?
Glucose
Serum
What is the fancy-ass dermatologic term for skin tag?
Acrochordon
What is a junctional nevi?
Nevus cells are at the dermal-epidermal junction just above the basement membrane zone of the epidermis
Not super elevated nevus
Are fried-egg nevi malignant?
No but they are in people with increased risk of melanoma development
What condition is basophilia seen in?
CML - chronic myeloid leukemia
What is the definition of acute leukemia?
Neoplastic proliferation of blasts
They are >20% of the bone marrow
What is a good way to test for ALL (acute lymphoblastic leukemia)
AML (acute myeloblastic leukemia) (2)
tdt positivity in nucleus
Myeloperoxidase and auer rod
What are the 2 subtypes of ALL? Which is most common?
B-ALL (most common)
T-ALL
What CDs are important in B-ALL?
CD10, CD19, CD20
What are the 2 translocations commonly seen in B-ALLL?
Prognosis?
Patient population?
t(12;21) Good prognosis. Children
t(9;22) Poor prognosis. Adults. This is the Philadelphia chromosome
What CDs are important in T-ALL?
2-8
No 10
Which hematologic malignancy has increased risk for DIC?
acute promyelocytic leukemia
What is a good way to test for acut emonocytic leukemia?
They don’t have myeloperoxidase
How id impetigo most commonly acquired?
Person-to-person contact
What is a rash on the cheeks with an indurated sharp border?
Erysipelas
What fungus causes jock itch and athlete’s foot?
Epidermophyton
What are the 3 common dermatophyte fungi? What do they eat?
Epidermophyton
Microsporum
Trichophyton
They eat keratin
What is the most common dermatophyte?
Trichophyton
What is a tinea infection that forms a plaque?
Kerion
What happens if you treat a fungal skin infection with topical steroids?
It goes into the hair follicles, because steroids reduce immune response
Inflammed follicles - Majocchi’s granuloma
Must treat with systemic steroids now
What does tinea look like with KOH?
Long, branching, septate hyphae
What is candidiasis on the corners of the mouth?
Perleche
What is candidiasis between the fingers?
Erosio interdigitalis blastomycetica chronica
What does tinea versicolor eat?
Follicular lipids (which is why its patient population is post-pubertal)
What fungal infection looks like spaghetti and meatballs with KOH?
Tinea versicolor
What is Klippel-Trenaunay syndrome?
Overgrowth of an extremity covered by a large port wine stain
Becasue of vascular abnormalities
What is the dermatologic dimple sign?
When you push in the sides, it indents
What is seborrheic keratosis?
A benign tumor of the hair follicle
Basal cell carcinomas arise from pluripotent cells due to mutations in the ___________ pathway
The most common mutant gene in this pathway is __________
Hedgehog
Patched 1
What is the most common pre-malignant skin lesion?
Actinic keratoses
The most important indicator of progress in melanoma is ________
Breslow depth
This is the maximal thickness of tumor invasion (mm)
What is the Clarck level?
It describes how what layer of the skin a melanoma has penetrated
I (epidermis) to V (subcutis)
Kaposi sarcoma is a cancer of _______
Endothelial cells
How do the wavelengths of UVA and UVB compare?
UVA is longer wavelength
3 types of DNA damage from UV radiation
Thymiine dimer
Pyrimidine-6-4 pyrimodone
Hydroxyguanosine
What 3 ways things can move into the skin?
Passive diffusion
Active transport
Transport via appendageal structures like sweat glands and hair follicles
What is the difference between and ointment and a cream?
Ointments are water in an oil emulsion
Creams are oil in a water emulsion
How do glucocorticosteroids affect the NF-KB pathway?
They inhibit it, leading to reduction in transcription of cytokines, adhesion mlcs, inflammatory enzymes, and growth factors
What 3 glucocorticosteroids do we care most about in derm?
In order of potency:
Hydrocortisone
Triamcinolone Acetonide
Clobetasol Propionate
What is a disadvantage to an ointment?
Patients may dislike greasiness
May stain clothing
What is a disadvantage to a cream?
Significant sensitization risk
What is a disadvantage to a gel?
Significant sentitizaiton risk
Relatively high irritaion risk
How many grams is a fingertip unit?
0.5
How is potency of topical steroids evaluated?
Vasoconstrictor assays
What are the 2 primary proinflammatory cytokines?
IL-1
IFN-Y
What enzyme excises mutated DNA strands?
UVR ABC nuclease
5 enzyme defenses against ROS in the epidermis
Peroxidase Catalase Superoxide dismutase Glutathione reductase Thioredoxin reductase
The rate limiting enzyme in the melanin production pathway is ___________________
Tyrosinase
What are 5 things UV light helps?
Psoriasis Atopic dermatitis Cutaneous T cell lymphoma Mastocytosis Vitiligo
What is the most common malignancy in teh US?
Basal cell carcinoma
What drug is used for basal cell carcinoma?
Vismodegib
What skin condition often becomes skin cancer?
Actinic keratosis (intraepidermal neoplasia)
What is Bowen’s disease?
Squamous cell carcinoma in situ
What is the gene most frequetly mutated in maloma?
BRAF
Which layer are epidermal stem cells in?
Stratum basalis
Where in the skin are desmosomes and hemidesmosomes?
Desmosomes connect epidermal cells
Hemidesmosomes connect the dermis and epidermis
What is the differentce between atopic dermatitis and contact dermatitis?
What is their clinical presentation (5)
They are both pruritic, erythematous, oozing rashes with vesicles and edema
Atopic dermatitis is a type 1 hypersensitivity where the irritant is not known. The irritant is known in contact dermatitis
What are 3 therapies for psoriasis?
Corticosteroids (topical)
UVA light - stops abnormal keratinocyte proliferation
Immune-modulating therapy
What are the 5 P’s of the lichen planus signs?
Prutitic, planar, polygonal, purple papules
What is the difference between pemphigus and pemphigoid?
Pemphigus - separation is in epidermis
Pemphigoid - separation of dermis and epidermis at the basement membrane
What are 2 worse forms of erythema multiforme?
What is the main difference, besides being worse?
Steven Johnson
TEN (toxic epidermal necrolysis)
They have oral mucosa involvement
What is the cause of erythema multiforme? What about Steven Johnson/TEN?
EM - herpes reaction most commonly but can also be autoimmune, drugs, or other pathogen
SJS is usually an adverse drug reaction
Leser-Trelat sign is a sudden onset of multiple _______
Seborrheic keratosis
What is the main genetic mutation (like on the molecular level) in basal cell carcinoma? What causes it?
Pyrimidine dimers
UVB
What skin condition is the precursors to squamous cell carcinoma?
Actinic keratosis
What are the 3 steps of mole growth?
Grow along the dermal-epidermal junction - junctional nevus
Extend down into nevus - compound nevus
Junctional component then disappears - intradermal nevus
What is the most common complication of polycythemia vera?
Acute clotting event
BCR-ABL always in ____________ and adult ____________ sometimes
CML
AML
Which cytokine (?) suppresses immune responses and is released by Tregs?
TGF-B
What cytokine is most responsible for the inflammatory reactions in the gut?
IL-6
What 3 grains is gluten in?
Wheat
Rye
Barley
What are Koch’s postulates showing that microbes cause specific diseases (4)
- Specific microbes are present regularly in characteristic lesions of the disease
- The specific microbes can be isolated and grown in vitro
- Injection of the cultured microbes into animals reproduces the disease seen in humans
- The specific microbes can be re-isolated from lesions of the disease in animals
In a virus, what is the RNA strand that contains the translatable open reading frame that is ‘ribosome-ready’?
+ strand
what is the eclipse period in viral infection?
Occurs after virus adsorption
When no infectious virus is detectable inside or outside the cell
This is because they have released their genomes into the cell
What is the latent period in viral infection?
The period between initiation of infection to the release of new viruses from the cell
What is the unique viral enzyme used to produce mRNA and replicate RNA?
RNA-dependent RNA polymerase
What are the 2 ways packaging of the genome into the capsid occurs in icosahedral capsids? What about helical nucleocapsids?
The capsid assembles around the virus genome
The genome is fed into preformed capsids
The viral genome is coated with nucleocapsid protein during its synthesis
What is viral tropism?
The fact that viruses infect some tissues and not others
Determined by access to tissue
Receptors
Expression of host genes required for virus infection and production of new progeny virus
Failure of host defences
Are enveloped or non-enveloped viruses hardier?
Non-enveloped ones
What is the difference between type I and II interferones?
Type I are made by infected cells
Type II are made by T and NK cells
What are the 4 things used to classify viruses
Genetic material: DNA/RNA
Capsid: helical/icosahedral
Naked/enveloped
Size
What is a spike in terms of viruses?
Virus-derived membrane-bound blycoproteins
What is the difference between a virus-susceptible and permissive cell?
Susceptible has a functional receptor for the virus
Permissive has capacity to replicate the virus
What is viremia?
The presence of viruses in the blood
What is APOBEC3G?
A human protein that interferes with the replication of HIV by incorporating itself into virus particles and damaging the genetic material of the virus
What is Vif?
An HIV protein that blocks APOBEC3G by
- binding to APOBEC3G
- Targeting APOBEC3G for destrution/elimination
What Type I IFNs (2) do we care about? What Type II IFN (1)
IFN-A, IFN-B
IFN-Y
What cells produce type II interferons?
T and NK cells
Type I interferons regulate control genes through ______________
Type I interferons do this through __________
ISREs (interferon-stimulated response elements)
GAS (gamma activated site elements)
Cells respond to interferons through receptor activation of _________ signalling
Jak/Stat
What are 2 mediators of hte IFN-induced anti-viral state we care about? They reduce protein production ultimately.
What are they activated by?
PKR - a protein kinases that decreases protein synthesis by inactivating some translation initiation factors
OAS - activates a cellular ribonuclease that degrades mRNA
Both are activated by dsRNA
How do drugs inhibit viral uncoating?
They block the virally-encoded H+ ion channel so that the pH change necessary for uncoating can’t occur
What is the nucleic acid of choice for herpes?
What is their capsid-shape?
Are they envoloped?
dsDNA (linear)
Icosahedral capsid
Envelope
What are the latentcy sites of the 3 herpes subfamilies?
Alpha - sensory ganglia
Beta - monocytes, lymphocytes
Gamma - B cells
How is herpes assembled? How does it leave the nucleus.
Assembly occurs in the nucleus and capsids self-assemble
Then the virus gets its envelope from the Golgi
Then it leaves through exocytosis or lysis
Which herpes is oral and which is genital?
HSV-1 -> orofacial/ocular lesions
HSV-2 -> genitals
Most commonly! Can actually be anywhere
Are most primary HSV infections symptomatic?
No
Where do latent HSV1 and HSV2 hang out?
1 - trigemnal ganglion
2 - sacral ganglion
Where is herpetic whitlow? Where does it come from?
Fingers
Oral secretions
Where is herpes keratitis?
Cornea
At what point is chicken pox no longer infected?
When all the lesions are scabbed (about 7 days)
Where does latent varicella zoster virus hang out?
Nerve ganglia associated with areas in which the virus was present in the skin
Does varicella zoster exhibit asymptomatic viral shedding in normal hosts that experience reactivation?
No! It is the only herpesvirus that does not.
What is the nucleic acid for influenza?
RNA
What are the 2 types of drugs we use to treat influenza?
Matrix protein inhibitors - only for subtype A
Neuraminidase inhibitors - for both subtypes A and B
What virus is the most common cause of bronchiolitis?
Respiratory syncytial virus
What is the nucleic acid for RSV?
ssRNA
What are F and G proteins for RSV?
F - fusion of viral envelope t host cell and membranes of infected cells (syncytia)
G - initial binding of virus to host cell
What is the difference between pemphigus and pemphigoid?
Pemphigus - epidermal separation
Pempigoid - dermal-epidermal separation
Proximal subungal white onchomycosis is associated with what other disease?
HIV
Proximal subungal white onchomycosis is due to ________
Trichophyton infection
Which dermatologic condition is on flexor surfaces? Which is on extensor surfaces?
Atopic dermatitis
Psoriasis
In chicken pox, do lesions present at the same stage?
no
Lesions are in multiple stages in the same body regions
Do shingles lesions cross the midline?
No
Where does CMV establish latency?
Monocytes and lymphocytes
Where does reactivated CMV shed?
Urine and saliva
How does acyclovir help reduce influenza infection?
Blocks nucleic acid synthesis
Terminates DNA chains (may only be in herpes)
Which drug blocks influenza nucleic acid synthesis?
Acyclovir
What do amantadine and rimantadine do in influenza infections?
Prevent viral uncoating by blocking H+ channel formation, thus preventing pH change necessary for uncoating
Which drugs (2) block influenza uncoating
Amantadine
Rimantidine
What do zanamivir and oseltamivir do in influenza infections?
Prevent viral release from cells
Which drugs (2) block influenza release from cells?
Zanamivir
Oseltamivir
Neuraminidase inhibitors are most effective when started within _______ hours after symptom onset
48
How is zanamivir administered?
Inhalation
Which drug prevents the herpes virus family from attaching to cells?
Docosanol
What does docosanol do?
Prevents herpes viral attachment to cells
What 3 drugs inhibit herpes family viral DNA polymerase?
Acyclovir
Roscarnet
Ganciclovir
What do acyclovir, roscarnet, and gancyclovi do?
Inhibit herpes viral DNA polymerase
What is resistance to acyclovir usually from?
Reduction or loss of expression of viral tyrosine kinase
What is the active form of vitamin D? What organ synthesizes it?
Calcitriol
Kidneys
Which UVR converts 7-dehydrocholesterol to vitamin D3?
UVB
What does the liver convert D2 and D3 to?
Calcidiol
What is the difference between eclipse and latent phases of viral infection?
Eclipse - no viruses detectable becaseu they are being replicated
Latent - period from infection until viruses are detectable outside cells
Cholera is _______ mediated
Pneumonia is _______cellular bacteria
TB is _____cellular bacteria
Toxin
Extra
Intra
What are viral spikes?
Virally-encoded glycoproteins
What is the nucleic acid for the herpes family?
dsDNA
What is a holocrine gland? Which one is on the skin?
A holocrine gland excretes whole cells
Sebaceous gland
What can you treat infantile hemangiomas with?
Beta blockers
Kaposi’s sarcoma is a malignancy of _______
Melanocytes
Malassazea furfur causes which 2 skin diseases?
Tinea versicolor
Seborrheic dermatitis
What are the 2 types of empetigo and which bacteria causes each?
Bullous - staph
Nonbullous - strep
What color is eumelanin?
Red/brown
What is the nucleic acid for RSV and influenza?
ssRNA
What is valacyclovir?
A prodrug of acyclovir that has better bioavailability
How does acyclovir dose compare between VZV and HSV?
VZV is less sensitive and requires higher dose
Within what time frame do you begin acyclovir treatment for stuff like shingles?
What is a cell resistant to viral infection?
It does not have receptors to allow the virus entry
What is FAMMM?
Familial atypical multiple mole melanoma
