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Test reviews DEDICATED > Day 5 June 25 > Flashcards

Day 5 June 25 Flashcards

1
Q

Treatment of cornybacterium diptheria

A

Diptheria antitoxin - IMPORTANT -preformed neutralizing antibodies that inactivate the circulating toxin
Antibiotics (penicillin, erythromycin)

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2
Q

MOA of diptheria toxin

A

Inhibits host protein synthesis (ADP-ribosylation of EF-2)-> local and systemic effects

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3
Q

what are potential systemic effects of the diptheria toxin?

A

life threatening cardiac (myocarditis) and neurological complication

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4
Q

Melanocyte origin

A

neural crest

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5
Q

Lung findings of asbestosis

A

Fibrosis and honeycombing, asbestos bodies (brown, beaded rods) and ferruginous bodies, pleural plaques are common

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6
Q

lung findings of chronic hypersensitivity pneumonitis

A

noncaseating granulomas, peribronchalar fibrosis and patchy lymphocytic infiltrates

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7
Q

cryptogenic organizing pneumonia lung findings

A

patchy fibrosis, fibroplastic plugs in the alveolar sacs and ducts, and a characteristic butterfly pattern

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8
Q

lung findings of idiopathic pulmonary fibrosis

A

patchy interstitial fibrosis
honeycomb pattern
Fibrosis prominently in the subpleural and perilobular regions
increasing collagen over time
Signs of chronic inflammation (lymphocytes?)

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9
Q

what is the gram stain of bortedella pertusis?

A

Gram negative coccobacillus

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10
Q

Retinitis pigmentosa pathophys

A
  • genetic disease characterized by retinil dystrophy
  • progressive dystrophy of the pigmented epithelium and photoreceptors
  • early disease primarily effects rods, but advanced disease will result in degeneration of cones as well
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11
Q

Presentation of retinitis pigmentosa

A

Early disease results in loss of rods leading to night blindness and peripheral vision loss. Later disease will progress to loss of cones resulting in decreased central vision acuity

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12
Q

Fundoscopic findings of retinitis pigmentosa?

A
  • retinal vessel attenuation
  • optic disc pallor
  • pigment accumulation (in a bone spicule pattern around vessels)
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13
Q

how does retinoblastoma present?

A

Leukocoria (white pupillary reflex), strabismus and a creamy white mass on fundoscopy

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14
Q

what causes acute rejection of organ transplant?

A

Mediated by T cells which react to the graft MHC antigens

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15
Q

in what time frame does acute rejection of organ transplant occur?

A

1-4 weeks

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16
Q

what will be different about a person with lactose intolerances stool?

A

It will have a lower pH -acidified stool

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17
Q

what will be different about a person with lactose intolerances breath?

A

it will have increased hydrogen content

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18
Q

which hormone is produced by duodenal cells in response to increased H concentrations?

A

Secretin - which stimulates Bicarb from the pancreas

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19
Q

what type of diuretic is spironalactone?

A

K sparing

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20
Q

how does estrogen effect osteoblasts?

A

increases their production of OPG, a decoy receptor that binds RANK-L which thus decreases its binding with RANK on osteoclasts decreasing bone resorption

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21
Q

Denosumab clinical use?

A

osteoporosis

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22
Q

Denosumab MOA?

A

monoclonal antibody that acts similarly to OPG

It binds the RANKL as a decoy and prevents binding with RANK on osteoclasts, thus decreasing osteoclast activity

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23
Q

what is the most common cause of bloody or serousanguineous (blood tinged) nipple discharge?

A

intraductal papilloma

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24
Q

A temporal lobe abscess from a prior bacterial infection may have gotten to the brain through what?

A

mastoid air cells

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25
Q

A frontal lobe abscess from a prior bacterial infection may have gotten to the brain through what?

A

ethmoid or frontal sinus

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26
Q

what is keratoderma blennorrhagicum?

A

vesicles on the palms and soles associated with reactive arthritis

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27
Q

what is circinate balanitis?

A

erpiginous ring-shaped dermatitis of the glans penis associated with reactive arthritis

28
Q

what mediates DIC in pregnancy?

A

tissue factor release which activates factor VII

-released from sites of placental injury

29
Q

is the rectum involved in crohsn disease?

A

no the rectum is SPARED in crohns disease

30
Q

what type of granumolas are found on biopsy of crohns disease?

A

NON-caseating

31
Q

which cytokine is important in the pathogenesis of crohns disease?

A

TNF- alpha

32
Q

which cytokine do macrophages secrete to induce immature t cells to differentiate into the Th1 subtype?

A

IL12

33
Q

A macrophage secretes IL12 to induce t cell differentiation into Th1. What happens next?

A

The Th1 cell secretes IFN gamma, which is important for macrophages nad CD8 cytotoxic t cells to get rid of intracellular pathogens

34
Q

what can you give a patient who is IL-12 deficient to improve response to mycobacteria?

A

IFN - gamma

35
Q

what is restricted in the diet of someone with a urea cycle disorder?

A

proteins - prevent excess ammonia

36
Q

ornithine is part of which cycle?

A

urea cycle where it combines with carbamoyl phosphate to produce citrulline

37
Q

what is cyclophosphamide metabolized into?

A

acrolein

38
Q

what is acrolein?

A

metabolite of cyclophosphamide that is excreted in urine but toxic to the uroepithelial cells

39
Q

complication of chemotherapy with cyclophosphamide or other nitrogen mustard agents?

A

hemorrhage cystitis due to acrolein

40
Q

how can you prevent hemorrhage cystitis in someone taking cyclophosphamide?

A

Agressive hydration and MESNA -inactivates toxic metabolites

41
Q

Leucovirin is the rescue drug for what?

A

methotrexate overdose

42
Q

Phenelzyine use?

A

monoamine oxidase inhibitor, thus increases presynaptic availabilty of monoamines

43
Q

why must you wait two weeks between taking a MOAi and SSRI?

A

risk of serotonin syndrome, so you need to wait for MAO to regenerate

44
Q

pathophys of neimann-pick disease?

A

sphingomyelins accumulate in lysosomes resulting in lipin-laden foam cells in the spleen and liver. Eventually accumulates in the nervous system as well

45
Q

list the steps in the adenoma to carcinoma sequence

A
  1. APC inactivation= normal colon -> hyperproliferative epithelium
  2. Kras mutation = hyperproliferative -> adenoma
  3. p53 inactivation = adenoma -> carcinoma
46
Q

What changes are seen 4-12 hours after an MI?

A

wavy fibers with narrow, elongated myocytes

47
Q

what changes are seen 12-24 hours after an MI ?

A

myocyte hypereosinophilia with pyknotic shrunken nuclei

48
Q

what changes are seen 1-3 days after an MI ?

A

coagulative necrosis and neutrophil infiltrate

49
Q

what changes are seen 3-7 days after an MI ?

A

dead neutrophils and myofibers

Macrophage infiltrates

50
Q

what changes are seen 7-10 days after an MI ?

A

granulation tissue

51
Q

name two highly conserved sequences used for initiation of transcription in humans?

A

CAAT and TATA

52
Q

what is the best measure of risk for a case control study?

A

odds ratio

53
Q

is the measure of relative risk commonly used for case controls?

A

NO this is used for cohort studies

54
Q

Inheritence of Crigler-Najjar syndrome type I?

A

AR

55
Q

What is deficient in Crigler-Najjar syndrome type I?

A

lack of UGT- enzyme needed to catalyze bilirubin with glucoronic acid

56
Q

pathophys of Crigler-Najjar syndrome type I?

A

The inability for the liver to conjugate glucoronic acid with bilirubin leads to a build up of UNconjugated bilrubin, which is not easily excreted as it binds tightly to albumin. It deposits in different tissues, including the brain, leading to kernicterus.

57
Q

What is deficient in Dubin Johnson?

A

absent biliary transport protein (MRP2) which excretes bile glucuronides into bile cannaliculi

58
Q

Inheritence of Dubin Johnson?

A

AR

59
Q

Findings in Dubin Johnson syndrome?

A

USually asymptomatic with black liver

60
Q

What is Rotor syndrome?

A

AR disroder with asymptomatic conjugated hyperbilirubinemia. Patients are jaundiced but live normal life

61
Q

Inheritence of Rotor syndrome?

A

AR

62
Q

Life expentancy in rotor syndrome?

A

Normal

63
Q

How is tetanus usually diagnosed?

A

Based on clinical presentation (bacteria only replicate at wound site and results would take days to come back, toxin assays are not widely available)

64
Q

MOA of donepezil?

A

Acetylcholinesterase inhibitor (used for alzheimers)

65
Q

Memantine MOA?

A

NMDA receptor antagonist (used for alzheimers)

Test reviews DEDICATED (70 decks)

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