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BECOM 3 > Exam #1 > Flashcards

Exam #1 Flashcards

1
Q

Auer rods
not very many
many

A

not very many : Acute myeloid leukemia (accumulation of MPO)

many: acute promyelocytic leukemia

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2
Q

t(15;17)

A
  • retinoic acid receptor mutation leading to RAR disruption

- acute promyelocytic leukemia (subtype of AML)

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3
Q

myeloperoxidase stains

A

myeloblasts

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4
Q

CD33 and CD34 positive

A

CD33: immature myeloid cells
CD34: multipotent stem cells
means acute myeloid leukemia (AML)

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5
Q

CD15

CD64

A

CD15 and CD64: mature myeloid cells

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6
Q

t(9:22) Philadelphia chromosome

  • outcome
  • causes
A
  • BCR-ABL protein fusion drives granulocytic and megakaryocytic progenitor proliferation
  • Chronic Myeloid Leukemia and bad prognosis ALL
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7
Q

Smudge cells

A

Chronic lymphocytic leukemia and SLL

-fagile lymphocytes (usually B cells)

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8
Q

M-CSF
G-CSF
G/M-CSF

A

M-CSF: monocyte
G-CSF: granulocyte
G/M-CSF: monocyte/granulocyte
-given after chemotherapy

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9
Q

Tdt stains for

A

lymphoblasts

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10
Q

Neutropenia causes

A

Acute viral syndromes
Rickettsial diseases
Chemotherapy

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11
Q

granulocytes

A

eosinophil
neutrophil
basophil

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12
Q

Atypical lymphocytosis (Downey Cells)

  • appearance
  • causes
A

RBC indent lymphocyte

-seen in EBV/CMV

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13
Q

Dohle Body

A
  • lighter than morulaes

- associated with left shifts and can be seen in conjunction with toxic granulation

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14
Q

Job’s Syndrome

A
  • hyper IgE (diagnostic)
  • retention of baby teeth
  • skin issues
  • facial abnormalities
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15
Q

Flower cells

A

Sezary syndrome

cutaneous CD4+ cell/T-cell lymphoma/leukemia

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16
Q

Hairy cells lineage and mutation

A

hairy cell leukemia

  • B cell leukemia that is a subtype of CLL
  • BRAF mutation
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17
Q

Morulae

A

dark spot in cytoplasm of cell that is darker than dohle body
-associated with Ehrlichiosis and Anaplasmosis

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18
Q

Rash associated with amoxicillin/ampicillin given

A

EBV

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19
Q

posterior cervical lymphadenopathy

A

EBV

Rubella

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20
Q

Epstein-Barr Virus type of autoimmune hemolytic anemia

A

IgM cold agglutinins

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21
Q

Plaque on the side of the tongue and cant scrape off unlike candida’s in which you can scrape
-associated with?

A

Hairy Cell Leukemia

-associated w EBV

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22
Q

Rapidly growing tumors around the mandible

A

Burkitt’s lymphoma (African form)

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23
Q

EBV can give rise to

A

Burkitt’s lymphoma (African form)
Hodgkin’s lymphoma
Nasopharyngeal carcinoma
Atypical lymphocytes (Downey cells0

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24
Q

Owl’s eyes

A

Hodgkin’s lymphoma (Reed-Sternberg cells)

CMV

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25
Q

Starry night pattern

A

Burkitt’s lymphoma

Reed-Sternberg cells of Hodgkins lymphoma disease

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26
Q

dormant hypnozoites in hepatocytes

A

P. vivax/ovale

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27
Q

banana shape on blood smear

A

P. falciporum

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28
Q

P. vivax
P. ovale
P. malariae

A

P. vivax - every 2 days
P. ovale - every 2 days
P. malariae -every 3 days

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29
Q

Severe symptoms of P. falciparum

A

Hemolytic anemia
Blackwater fever: hemolytic crisis with severe anemia, black urine, oliguria/acute renal failure from hemoglobinuria, jaundice

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30
Q

Malaria stain

A

Wright’s or Giemsa stain

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31
Q

ringforms in RBCs

A

Falciparum if high parasitemia (>60%) all others roughly 1-2%

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32
Q 
artemisinins
Atovaquone-proguanil
Chloroquine
Primaquine
Quinine plus Clindamycin
Quinidine

why to give

A 
artemisinins - get from WHO
Atovaquone-proguanil - go to drug in US mild-moderate severity
Chloroquine - north of Panama Canal 
Primaquine - kill vivax and ovale
Quinine plus Clindamycin - pregnant
Quinidine - IV is severe
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33
Q

Chloroquine contraindications

A

psoriasis or porphyria

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34
Q

Primaquine contraindications

A

Pregnancy (fetus lack G6DPH)

G6PDH deficient patients

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35
Q

Atovaquone-proguanil
Chloroquine
Quinine & Quinidine
Artemisinin

MOA

A

Atovaquone-proguanil: inhibits ETC
Chloroquine: blocks heme polymerization
Quinine & Quinidine: blocks heme polymerization
Artemisinin: Inhibition of nucleic acid and protein synthesis

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36
Q

Neutrophilia causes

A

corticosteroids
epinephrine –> demargination
infection (C. diff)
inflammation

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37
Q

Eosinophilia causes

A

Parasitic infections

Allergies

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38
Q

Job’s syndrome

A

Hyper IgE
retention of baby teeth
plaque on tongue cannot be remove like candida

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39
Q

Basophilia causes

A

CML (BCR-ABL positive)

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40
Q

Neutropenia causes

A

Acute viral syndromes
Rickettsial diseases- Ehrlichiosis/Anaplasmosis
Chemotherapy and radiation therapy

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41
Q

2 lobed “dumb bell” neutrophil

A

Pelger-Huet anomaly

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42
Q

Long Island, Fire Island, Shelter Island, Nantucket Island and Martha’s Vineyard in the northeast US

A

Babesiosis

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43
Q

Babesios treatment

A

Atovaquone + axithromycin

Clindamycin + quinine

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44
Q

Powassan virus causes

A

neurological issues

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45
Q

Tick borne illnesses confections Ixodate bites

A

Babesios
Anaplasmosis
Powassan
Borrelia burgdorferi

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46
Q

difference between folate and B12 def

A

B12 present with neurological symptoms but after a long time

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47
Q

vitamin K dependent factors

A

II
VII (most sensitive)
IX
X

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48
Q

hemophilia A
hemophilia B
mutation and test

A

hemophilia A: mutated factor VIII (carried by mom and given to son)
-prolonged PT, normal PT
hemophilia B: mutated factor IX
-prolonged PT, normal PT

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49
Q

von Willebrand disease (type 1,2,3)

A 
mutated (2) or def. (1,3) vWF
type 1: mild-moderate (def. in vWF)
type 2: defective multimer assembly
type 3: severe (very low vWF)
-lead to dec VIII bc stabilizes VIII
-normal platelets
-prolonged PTT
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50
Q

von Willebrand factor purpose

A
  • Binds to exposed collagen and GPIb receptor on platelet surface
  • Activated platelets release ADP & thromboxane A2 (TXA2)
  • Carries/protects of Factor VIII
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51
Q

tissue plasminogen activator (t-PA)

A

enzyme that converts plasminogen to plasmin which breaks down fibrin and some clot factors

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52
Q 
Heparan sulfate
Thrombomodulin
Protein C
Plasmin
Antithrombin
A

Heparan sulfate: Activates antithrombin
Thrombomodulin: binds to thrombin
Protein C: inactivates factors Va and VIIIa
Plasmin: degrades fibrin (D-dimers and FDP)neutralizes Antithrombin: inactivates thrombin and clotting factor Xa

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53
Q

what will vitamin K immediately effect when low

A

Factor VII (extrinsic but not intrinsic pathway) and protein C bc they have short half lives

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54
Q

Heparin inhibits

Warfarin inhibits

A

Heparin: 12, 11, 9, 10, 2
Warfarin: 10, 9, 7, 2

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55
Q

normal platelet count

A

150,000 - 450,000

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56
Q

ADAMTS13 (vWF metalloprotease) def.

A

Thrombotic thrombocytopenic purpura (TTP)

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57
Q

Heparin-induced thrombocytopenia (Type I and II)

A

Type I: direct activation of platelets
Type II: antibodies (IgG) that recognize complexes of heparin and platelet factor 4, Fc region of antibody binds platelet causing activation –> severe thrombosis

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58
Q

immune thrombocytopenic purpura

A

Adult: autoantibody that destroys platelets (chronic in adults) usually secondary to SLE, HIV
Children: autoantibody that destroys platelets after viral infection (acute bc resolves after about 6 months)

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59
Q

Bernard-Soulier syndrome

A

deficiency of platelet membrane glyco­protein complex Ib-IX

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60
Q

Glanzmann thrombasthenia

A

defective platelet aggregation from deficiency or dysfunction of glycoprotein IIb-IIIa

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61
Q

Disorders of platelet secretion (storage pool disorders):

A

Defective release of mediators of platelet activation, unusual bleeding (after surgical procedure)

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62
Q

DiGeorge syndrome

A

Thymic hypoplasia

  • 22q11.2 deletion syndrome (3/4 pharyngeal pouches)
  • heart defect (ventricular septal defect)
  • hypoparathyroidism (parathyroid disfunction
  • cleft palate
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63
Q

Thymic hyperplasia (true vs. follicular)

A

True: inc size while maintaining normal architecture
Follicular: inc in B cell follicles

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64
Q

dermatitis herpetiformis

A

autoimmune blistering disorder that is associated with celiac disease (gluten sensitivity)
-immunofluorescence showing immunoglobulin A (IgA) in the papillary dermis

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65
Q

pernicious anemia

A

autoimmune destruction of parietal cells that release intrinsic factor resulting in malabsorption of B12

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66
Q

dactylitis

A

sickle cell anemia

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67
Q

CD 55 and CD 59

A

proximal nocturnal anemia

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68
Q

pseudohyphae

A

candida

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69
Q

narrow budding yeast

A

cryptococcus neoformis

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70
Q

pediculosis

A

lice

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71
Q

Cutaneous larva migrans

A

hook worm

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72
Q

Cutaneous Leishmaniasis

A

transmitted by sand fly

soldier returning from Middle East

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73
Q

Paronychia

A

Infection around a nail

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74
Q

Panniculitis

A

inflammation of subcutaneous fat

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75
Q

hyaluronidase

A
  • Staphylococcus aureus and in Group A Streptococcus
  • an extracellular enzyme that helps destroy some the polysaccharides that hold cells together, allowing these bacteria to spread through the tissues of the host
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76
Q

M proteins

A

on Streptococcus prevent opsonization by complement, making it more difficult to be phagocytized

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77
Q

Skin infections in unvaccinated children

A

Haemophilus influenza

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78
Q

dog and cat bites

A

Pasteurella

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79
Q

Wound infections after human bites

A

Eikenella corrodens

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80
Q

rat bite

A

Streptobacillus moniliformis and Spirillum minus

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81
Q

snakebites

A

Pseudomonas aeruginosa

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82
Q

Puncture/nail wounds through shoes that lead to infection

A

Pseudomonas aeruginosa

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83
Q

groin and axillary regions that fluoresce coral red with a Wood’s light (dark reddish/brown appearance)

A

Erythrasma

Corynebacterium minutissimum

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84
Q

Erythrasma vs Candida skin infection

A

Erythrasma: reddish brown with no satellite lesions
Candida: bright red with satellite lesions
-both interigo found in body folds

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85
Q

Panton-Valentine Leukocidin

A

Staph. aureus exotoxin

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86
Q

Nikolsky sign

A

when touched, and cleaves just below the stratum corneum

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87
Q

Fournier’s gangrene

A

necrotizing fasciitis that tends to occur in the perineum, groin and proximal thighs

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88
Q

Hidradenitis suppurativa

A

dysfunction of apocrine sweat glands and hair follicles causing recurrent inflammatory nodules develop in those areas, are painful and tend to break open leading to secondary, draining abscesses

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89
Q

raw oysters with liver failure or chucking oysters leading to necrosis fasciitis

A

Vibrio vulnificus

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90
Q

fish tank exposure

A

Mycobacterium marinum

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91
Q

45 degree hyphae on silver stain

A

Asperillosis

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92
Q

90 degree hypae on silver stain and association

A

Zygomycetes (Mucormycosis)

-associated with mucor lesion bc invades blood vessels which leads to ischemic/necrotic tissue

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93
Q

Tzanck smear with multinucleated giant cells

A

HSV 1/2

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94
Q

Varicella Zoster Virus can lay dormant in the…

A

dormant (latent) in the trigeminal and dorsal root ganglia

-trigeminal nerve can put the cornea at risk

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95
Q

how to distinguish between Varicella Zoster Virus and Variola Virus (small pox)

A

Varicella Zoster Virus:

  • develops in crops over time
  • doesnt include palms and soles
  • sickness isn’t as severe

Variola Virus:

  • crop develops at same time
  • include palms/soles
  • much more severe sickness
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96
Q

HVV6/7 (Roseola) vs Rubeola (measles)

A

Roseola

  • rash: trunk -> extremities
  • febrile seizures
  • not as sick as rubeola

Rubeola

  • Koplik’s spots
  • cough, conjunctivitis and coryza (stuffy, runny nose)
  • rash starts at back of ears and runs down body
  • severely sick
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97
Q

HVV 8 is associated w

A

Kaposi’s sarcoma: angioproliferative tumor usually on the nose or inside the mouth

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98
Q

Herpes B virus(Herpes simiae) is commonly from

A

monkey bite

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99
Q

Hand, Foot and Mouth Disease cause and symptoms

A

Coxsackie virus A 16 and Enterovirus 71

-rash on the hands, feet, and inside the mouth

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100
Q

Herpangina cause and symptoms

A

Coxsackie virus A and B, Enterovirus 71

-grayish lumps form and develop into vesicles surrounded by erythema in the mouth and pharynx

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101
Q

Parvovirus B19

A

aka slap cheek or fifth disease

  • children: red rash forms on cheeks and spares the nasolabial folds, forehead and mouth
  • adults: palyarthrogias similar to RA
  • bone marrow suppression and pancytopenia in immune compromised patients (AIDS), even leading to aplastic crisis
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102
Q

subacute sclerosing panencephalitis

A
  • progressive brain inflammation caused by persistent infection with measles virus, which can be a result of a mutation of the virus itself
  • occurs in rubeola (measles)
  • give vitamin A
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103
Q

F protein

A
  • rubeola

- mediates cell-to-cell fusion of infected to uninfected cells, forming giant cells

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104
Q

Mumps symptoms

A
  • parotitis

- orchitis (red swollen testicles)

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105
Q

Rubella (German Measles) symptoms

A
  • lymphadenopathy involves posterior cervical, posterior auricular and suboccipital nodes
  • petechia on soft palate (*Forshheimer spots)
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106
Q

Acute HIV

A
  • Days-weeks after exposure 50-90% experience symptoms of acute (i.e. primary infection) HIV, which is a mononucleosis-like symptoms
  • RETRO-ORBITAL headache
  • macular or maculopapular rash is non-pruritic, mostly on the upper body
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107
Q

Human Papillomavirus associated with

A

cervical and oropharyngeal cancers

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108
Q

Orf virus

A

handling infected sheep or goats

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109
Q

Molluscum Contagiosum

A

water warts

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110
Q

Dengue Fever vs. Chikungunya Fever symptoms

A

Dengue Fever (South/Central America, Australia, Africa)

  • retro-orbital headache
  • biphasic/saddleback fever
  • “Islands of white in a sea of red” rash
  • Faget’s sign

Chikungunya Fever
-same as Dengue fever but severe arthralgias

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111
Q

Heterophile antibody test

A

aka monospot test used to test for EBV

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112
Q

Give amoxicillin/ampicillin to EBV

A

hypersensitivity reaction rash all over body involving palms

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113
Q

anemia associated with EBV

A

autoimmune hemolytic anemia with IgM cold agglutinins

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114
Q

X-linked lymphoproliferative syndrome/Duncan’s syndrome

A
  • associated in males develop during primary exposure

- a large proliferative response of polyclonal B/T cells, along with macrophages, in response to primary EBV infection

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115
Q

how to tell the difference between oral hairy cell leukemia and candida?

A

Oral Hairy Leukemia: can’t scrape of oral plaque

Candida: can scrape off oral plaque

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116
Q

cancers associated with EBV

A

Oral hairy cell leukemia
Hodgkin’s lymphoma
Burkitt’s lymphoma (afrcan epidemic)
NASOPHARYNGEAL CARCINOMA

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117
Q

B symptoms

A
  1. fever of more than 38°C for at least three days
  2. drenching night sweats
  3. unintentional weight loss >10% over a six-month period
    - associated with Hodgkin’s and Non Hodgkin’s lymphoma and sometimes Tb
    - these cancers can be associated w EBV
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118
Q

CMV illness association

A

CMV is the most common cause of fatal myocarditis in immunocompetent people

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119
Q

most common pathogen in liver transplant patients?

A

CMV

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120
Q

Involucrum

A

Layer of new bone growth, outside of existing bone (heterotopic ossification) that is infected, often surrounding a sequestrum
-associated with chronic osteomyelitis

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121
Q

Brodie’s abscess

A

an abscess walled off by fibrous and granulation tissue, usually associated with chronic osteomyelitis where frank bone and marrow tissue has been absorbed

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122
Q

Pott’s Puffy Tumor

A

a subperiosteal abscess due to osteomyelitis of the frontal bone of the skull as a result of acute or chronic sinusitis, intranasal cocaine or methamphetamine abuse or frontal sinus surgery

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123
Q

Osteomylitis in adults and children (location)

A

Adults: epiphysis
Children: metaphysis

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124
Q

Pott’s disease

A

osteomyelitis in the spine often caused by Tb

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125
Q

Batson’s plexus of veins

A

how infections (osteomyelitis) can spread from GI/GU (gram neg. rods) to the spinal cord

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126
Q 
Osteomyelitis/Septic arthritis 
Kids:
Nail through shoe:
Unvaccinated kids:
Sickle Cell:
Animal Bite:
Human Bite:
A

Kids: Kingella or Streptococcus agalactiae
Nail through shoe: Pseudomonas aeruginosa
Unvaccinated kids: Haemophilus influenzae
Sickle Cell: Salmonella
Animal Bite: Pasteurella or Bartonella
Human Bite:Eikenella and Strep. viridans

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127
Q

Sinus tracts to skin are often seen with chronic osteomyelitis cancer

A

squamous cell carcinoma

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128
Q

Nuclear medicine 3 phase bone scan

A

shows hot spots in bone (osteomyelitis)

-MRI is the diagnosis tool of choice

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129
Q

In sexually active young adults under 40, the most common cause of spontaneous, hematogenous, septic arthritis…

A

disseminated gonococcal infection

  • tends to develop either around a recent menstrual period (within 7 days of start of menses) or post-partum
  • lesion on hands
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130
Q

Viscosity drop test results meaning

A

-if the drop does not string –> infection/inflammation

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131
Q

Reactive arthritis symptoms

A

Triad: arthritis, conjunctivitis, and urethritis

  • cant see, cant pee, cant climb a tree
  • autoimmune reaction by prior infection of genitourinary system usually chlamydia
  • Reiter’s Syndrome
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132
Q

G-CSF (Filgrastim/tradename-Neupogen) vs. G-CSF/polyethylene glycol

A

G-CSF (Filgrastim/tradename-Neupogen): short half-life
G-CSF/polyethylene glycol: longer half-life
-used in individuals with chemotherapy

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133
Q

Neutrophilia causes

A

corticosteroids/epinephrine: demmargination

Increased production: infection

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134
Q

Neutrophilia lab amount

A

25,000-50,000

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135
Q

Philadelphia chromosome and/or BCR-ABL gene mutation seen in

A

CML

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136
Q

Lymphocytosis causes

A

Increased bone marrow release: infection

CLL/ALL

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137
Q

Eosinophilia causes

A

Allergic disorders (asthma)
Parasitic infections
SLE
Hodgkin’s disease

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138
Q

Hyper IgE syndrome (Job’s syndrome)….

A

High IgE
rendition of baby teeth
skin issues
weird fascial features

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139
Q

Monocytosis causes

A

TB infection

acute monocytic leukemia, chronic myelomonocytic leukemia, Hodgkin’s disease

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140
Q

Basophilia causes

A

CML

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141
Q

Neutropenia causes

A 
Acute viral syndromes
Chronic viral syndromes (HIV)
Rickettsial diseases
Autoimmune diseases (SLE, RA)
B12 and folate deficiency
Ethanol direct toxicity in the bone marrow 
Chemotherapy and radiation therapy
Methotrexate
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142
Q

Neutropenic Fever

A

A common complication seen during the neutropenic period, that tends to occur 7-14 days after a typical round of chemotherapy. The neutropenia lasts several days and can be profound with <100 total neutrophil count. Shortened, and often less severe, if G-CSF is given prophylactically by the Oncologist.

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143
Q

Pelger-Huet anomaly

A

dumbbell-shaped basophils

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144
Q

Sezary syndrome

A

advanced stage mycosis fungoides (cutaneous CD4+ cell)

-Sezary cells: convoluted (“cerebriform”) or flower cells

145
Q

thymus embryonic origin

A

3/4 pharyngeal arch

146
Q

myasthenia gravis association

A

thyoma

147
Q

Digeorge Syndrome

A

thymic hypoplasia

  • 22q11 partial deletion (envolves 3 /4 pharyngeal arches)
  • heart defect (ventral septal), hypoparathyroidism (low Ca2+), cleft palate
148
Q

Thymus sections and residents

A

Cortex: developing T cells and macrophages
Medulla: Hassalls corpuscles, immunocompetent T-cells, macrophages, dendritic cells

149
Q

thyoma types

A

Noninvasive thymomas: composed of medullary type epithelial cells
Mixed thymomas: medullary, and polygonal cortical type epithelial cells
Invasive thymoma: epithelial cells most commonly cortical (more likely to metastasize)

150
Q

thymic carcinoma association

A

EBV

151
Q

White pulp
Marginal Zone
Follicle
Periarteriolar Lymphatic Sheath

A

-Marginal Zone: macrophages that remove debris and dendritic cells processing antigens
Follicle: B cells
Periarteriolar Lymphatic Sheath (PALS): surrounds arteries (T cells)
KNOW ANATOMY

152
Q

Red pulp

A

where macrophages remove old RBCs and where platelets are stored
-sinusoids: allow RBC to pass through to get to the cords of Billroth where macrophages are located

153
Q

Sinusoids

A

cause cells extreme deformation so RBCs get trapped in the cords and are readily phagocytosed

154
Q

Congestive splenomegaly

A

Caused by chronic venous outflow obstruction with portal or splenic vein hypertension

  • Liver cirrhosis
  • spontaneous portal vein thrombosis
  • R sided heart failure
155
Q

Spleen function

A
  • phagocytize RBCs
  • antibody production (dendritic cells -> T cells -> B cells)
  • hematopoiesis (fetus, chronic anemia)
  • sequestration of blood elements (platelets, RBCs)
156
Q

elevated ASO

A

recent strep infection

157
Q

Heinz bodies are found in

A

G6P def. anemia

-use Heinz prep to test for G6P def anemia

158
Q

Desmopressin

A

increases release of vWF from Weibel-Palade bodies

159
Q

RANK

RANKL

A

RANK: osteoclast
RANKL: osteoblast
-binding leads to survival of osteoclasts by osteoblasts releasing M-CSF
-PTH increases RANKL on osteoblasts

160
Q

WNT

A

binds to osteoblasts and produces OPG which competitively binds to RANK inhibiting the production of osteoclasts

161
Q

Osteopetrosis

A

Adult autosomal dominant, chloride channel dysfunction

162
Q

Osteitis fibrosa cystica

A

loss of bone mass, weak bones as calcified structures replaced with fibrous tissue (peritrabecular fibrosis), and formation of cyst-like brown tumors
-High PTH results in high osteoclastic activity

163
Q

Osteonecrosis (avascular necrosis) cause

A

fractures
corticosteroids
predisposed alcohol abuse
bisphosphonate therapy

164
Q

Rheumatoid factor

A

serum IgM or IgA autoantibodies that bind Fc parts of IgG

165
Q

Mononeuropathies
Mononeuritis
Polyneuropathies
Polyradiculoneuropathies

A
  • Mononeuropathies affect single nerve, deficits in restricted distribution dictated by normal anatomy; causes are trauma, entrapment, infections
  • Mononeuritis multiplex damages several random nerves; commonly vasculitis
  • Polyneuropathies affect multiple usually symmetrical nerves and axons effects are length dependent, so deficits start in feet and ascend; “stocking and glove”; example is diabetic neuropathy
  • Polyradiculoneuropathies affect nerve roots and peripheral nerves (polyneuropathy and polyradiculopathy occur together), diffuse symmetric symptoms proximally and distally; example is Guillain–Barré syndrome
166
Q

Guillain-Barré Syndrome

A

immune-mediated demyelinating neuropathy

-beginning in distal limbs, rapidly advancing proximally, “ascending paralysis” (distal –> proximal)

167
Q

Dermatomyositis antibodies

A

Anti-Mi2: gottron papules and heliotrope rash
Anti-Jo1: interstitial lung disease, nonerosive arthritis, mechanic hands
-elevated CK

168
Q

Dystrophin

A
  • forms interface between cytoskeletal proteins and group of transmembrane proteins
  • mutations in dystrophin are associated with X-linked muscular dystrophies
169
Q

X-Linked Muscular Dystrophy with Dystrophin Mutation/Duchenne and Becker Muscular Dystrophy

A
  • Pseudohypertrophy of leg
  • Positive Gowers’ sign
  • Serum creatine kinase elevated
  • Absence of dystrophin
  • Fat replaces muscle
170
Q

Lucent lesion

A

punched out (osteolytic) bright on X-ray

171
Q

osteoma association

A

Gardner’s Syndrome (colin polyps)

172
Q

OSTEOID OSTEOMA on xray

A

round lucent nidus surrounded by extensive sclerosis

-can look targetoid

173
Q

what makes someone at risk for osteosarcoma

A

RB, Paget’s

174
Q

Maffuci’s syndrome vs Ollier’s syndrome

A

Maffuci’s syndrome: multiple chondromas and soft tissue hemangiomas

Ollier’s syndrome: multiple enchondromas

175
Q

Chondroma associated rearrangement

A

11q13-15

176
Q

Chondroblastoma histology resembles

A

chicken wire

177
Q

Chondrosarcoma xray description

A

rings and arcs

178
Q

Ewing’s sarcoma arises from

A

neural ectoderm

179
Q

osteoblastic tumors

A

Prostate
SCLC
Hodgkin lymphoma
Medulloblastoma

180
Q

What infectious diseases have rashes that typically involve the palms and soles?

A

Coxsackievirus

Rocky Mountain Spotted Fever

181
Q

Where is vWF located

A

Weibel-Palade bodies of endothelium

Alpha granules of platelets

182
Q

markers for Chronic Lymphocytic Leukemia (CLL)

A

CD5 CD20

183
Q

severe anemia, black urine, oliguria/acute renal failure from hemoglobinuria, jaundice (from indirect hyperbilirubinemia)

A

P. falciparum

184
Q

Chloroquine MOA and contraindication

A

blocks heme polymerization into hemozoin causing a buildup of heme
contraindication: psoriasis/porphyria, vision issues

185
Q

Primaquine indication and contraindication

A

Indication: infection of vivax and oval or render falciparum gametes noninfective to mosquitoes
Contraindication: G6P def. and pregnancy (bc G6P def.)
-Primaquine effects parasites mitochondria causing build up of ROS, this can exacerbate a G6P def.

186
Q

Atovaquone + Aguanil MOA

A

Atovaquone: disrupting mitochondrial electron transport
Aguanil : inhibitor of the parasites dihydrofolate reductase-thymidylate synthetase (enhances atovaquone effect)
indication: falciparum infection

187
Q

Mefloquine indication and contraindication

A

indication: drug of choice for chemoprophylaxis against chloroquine-resistant strains of malaria
contraindication: epilepsy and cant give with Quinidine and quinine

188
Q

Quinine & Quinidine indication and contraindication

A

indication: sever falciparum infection
contraindication: mefloquine, can raise warfarin/digoxin levels

189
Q

Artemether MOA, indication

A

MOA: prodrugs that causes inhibition of nucleic acid and protein synthesis
indication: severe falciparum infection

190
Q

Pyrimethamine + sulfdoxine MOA

A

MOA: Synergist effects which acts slowly against erythrocytic forms of susceptible strains of all four human malaria species (blocks folate production in parasite)

Contraindication: if given to pregnant women must supplement with folate (blocks folate production in parasite)

191
Q

Pernicious Anemia

A

autoimmune destruction of parietal cells leading to dec intrinsic factor

192
Q

B12, Fe2+ are absorbed where

A

B12: ileum

Fe2+: distal duodenum

193
Q

Hepcidin

A

decrease Fe2+ release from enterocyte (dec ferroportin) and macrophages as well as decreasing EPO

  • low when iron stores decrease or when erythropoiesis is stimulated
  • high whenstorage sites full of iron and erythropoiesis normal
194
Q

alpha/beta thalassemia chromosomes

A

alpha: 16
beta: 11

195
Q

Silent carrier state
α-Thalassemia trait
HbH disease
Hydrops fetalis

A

Silent carrier state: 1 deletion

α-Thalassemia trait: 2 deletions (mild anemia)

HbH disease: 3 deletions tetramers of β-globin form HbH (high affinity for oxygen with tissue hypoxia)

Hydrops fetalis: 4 deletions γ-globin chains form tetramers (hemoglobin Barts) with a high affinity for oxygen that deliver little oxygen to tissues

196
Q

β-thalassemia major

A

β 0 / β 0

  • ineffective erythropoiesis causes massive erythroid hyperplasia in marrow and extensive extramedullary hematopoiesis -> “crewcut”
  • target cells
197
Q

IL-6 stimulates an increased

A

hepatic hepcidin seen in chronic inflammatory states

198
Q

spherocytosis

A

Howell-Jolly bodies
autosomal dominant
splenectomy

199
Q

paroxysmal nocturnal hemoglobinuria doesnt have

A

glycosylphosphatidylinositol (GPI)-anchored proteins, CD55 and CD59 (DAF)
-inhibit C3 convertase

200
Q

IgM vs. IgG

A

IgM: fixes compliment (cold)
IgG: macrophage destruction (warm)

201
Q

Holly-Jowell bodies

A

emerges on blood smear following splenectomy in a patient with hereditary spherocytosis

202
Q

pentad of symptoms seen in thrombotic thrombocytopenic purpura (TTP)

A

FAT RN:

F: Fever
A: Anemia (MAHA)
T: Thrombocytopenia

R: Renal symptoms
N: Neurologic symptoms

203
Q

Marker difference between ALL and CLL

A

ALL: CD10, 19, 20, 22
CLL: CD5, 19, 20, 23
-CD5 differentiates the two plus involvement of lymph nodes in CLL (specifically SLL)

204
Q

HTVL-1 causes

A

Adult T cell leukemia/lymphoma

205
Q

t(14;18)

A

BCL-2 translocations

follicular lymphoma

206
Q

Diffuse large B-cell lymphoma (DLBCL) immunophenotype had mutation

A

Positive CD10, CD19 and CD20, and BCL6

207
Q

CD19, CD20, usually CD5 positive and CD23 negative

-what can this be confused with

A

Mantle cell lymphoma

-CLL will have CD23 and CD5

208
Q

t(11;14)

A

overexpression of cyclin D1

Mantle cell lymphoma

209
Q

HHV-8 causes

A

Kaposi sarcoma

210
Q

Lymphoplasmacytic Lymphoma causes

A

secrete usually monoclonal IgM, but can also be IgG or IgA that causes hyperviscosity syndrome called Waldenström macroglobulinemia

211
Q

CD15/30

A

Hodgkin’s lymphoma (Nodular sclerosis type)

212
Q

CD 138/56

A

multiple myeloma

213
Q

mutations in transcription factor STAT3

A

Large granular lymphocytic (LGL) leukemia

  • T-cell variants are CD3+
  • NK-cell CD3−, CD56+
214
Q

Erythema multiforme and associated diseases

A

immune related symmetrical targetoid lesions following a HSV1/2 infection

  • Steven Johnson Syndrome: 10-30% children
  • Toxic Epidermal Necrolysis: >30% elderly
215
Q

psoriasis histology

A

elongation of dermal papillae (test tubes in a rack)

216
Q

Pemphigus vulgaris

A

Dsg 1 and Dsg 3
antibodies throughout epidermis
bullae rupture easily

217
Q

Pemphigus faliaceus

A

Dsg 1

218
Q

Bullous pemphigus

A

BAPG (hemidesmosomes)
antibodies along dermal/epidermal junction
-tense bullae that won’t rupture

219
Q

Seborrheic Keratosis

A

liver spot associated with GI carcinoma

linear melanocyte hyperplasia

220
Q

Nevi main mutation

A

BRAF

221
Q

Acatinic Keratosis

A

leads to squamous cell carcinoma

222
Q

Squamous cell carcinoma histology give away

A

keratin pearl

223
Q

Dermitis Herpetiforms

A

IgA antibody against reticulin (helps anchor BM)

  • antibodies at tips of dermal papillae
  • associated with gluten allergy
224
Q

RMSF

A

Rickettsia rickettsia

  • rash starting on wrist/ankles -> palms, soles, trunk
  • edema and intra-vascular volume depletion due to vascular leak
225
Q

American Tick Bite Fever vs. African Tick Bite Fever vs. Boutonneuse/Mediterranean Fever

A

American Tick Bite Fever: single eschar at bite site
-south US

African Tick Bite Fever: multiple eschars

Boutonneuse/Mediterranean Fever: single, large eschar
-around Mediterranean seas

-all caused by rickettsia virus

226
Q

Human Monocytic Ehrlichiosis

A
  • morulae in monocyte/macrophage
  • south US
  • Amblyomma americanum
  • Leukopenia, Thrombocytopenia, Elevated transaminases,
227
Q

Anaplasmosis

A

Anaplasma phagocytophilum

  • north and northeast, CA, Europe
  • Ixodes scapularis and pacificus
  • morulae occur in granulocytes
228
Q

Tularemia

A

Francisella tularensis

  • passed by ticks and flies
  • ULCEROGLANDULAR
  • Faget’s sign (high temp, low/normal pulse)
229
Q

Tularemia treatment

A

Quinolones or Doxycycline or Gentamicin

230
Q

Q fever

A
  • undergoes biphasic antigenic variation without morphologic changes
  • Phase II antibodies in ACUTE
  • Phase I antibodies CHRONIC
231
Q

STARI

A

Amblyomma americanum

targetoid erythema chronicum migrans lesion usually smaller than Lyme disease

232
Q

Powassan Virus

A

meningoencephalitis

233
Q

Lyme Disease

A

Borrelia burgdorferi sensu lato

  • sphirocytes seen on histo
  • erythema chronicum migrans that increases in size
  • BELL’S PALSY
  • conjunctivitis
234
Q

Erythema multiforme vs. Lyme disease vs. STARI

A

Erythema Multiforma: targetoid lesions on palms and soles
Lyme disease: large targetoid lesion that grows over time
STARI: small targetoid lesions

235
Q

Co-infection with Ixodes ticks

A

Lymes Disease, Anaplasma, Babesia and Powassan virus

236
Q

Colorado Tick Fever

A

-biphasic illness starting around 1 week after a bite

237
Q

Bartonella

A

localized lymphadenopathy

238
Q

Amblyomma tick infections

A

ATBF
HME
Q fever
STARI

239
Q

schistocytes

A

thrombotic thrombocytopenia purpura

hemolytic uremia syndrome

240
Q

thrombotic thrombocytopenia purpura vs hemolytic uremia syndrome

A

thrombotic thrombocytopenia purpura: ADAM13 def. resulting in large vWF multimers leading to abnormal platelet adhesion -> microthrombi
-neurological symptoms

hemolytic uremia syndrome: damage to endothelium (usually E. coli) resulting in platelet thrombi
-renal failure, diarrhea

Both:

  • skin/mucosal bleeding
  • MAHA
  • fever
  • normal PT/PTT
  • schistocytes
241
Q

immune thrombocytopenic purpura

A

adults: secondarily to SLE, HIV, B-cell neoplasms like CLL/SLL
children: acute ITP by unknown mechanism that trigger autoantibodies
- autoantibodies mostly against platelet membrane glycoproteins IIb-IIIa or Ib -IX

242
Q

will vWF have a prolonged PT or PTT and why

A

prolonged PTT bc vWF stabilize clot factor VIII so there will be a def in VIII as well leading to a decreased VIII

243
Q

Warfarin Test

A

PT

244
Q

Heparin test

A

PTT

245
Q

vWF disease vs Hemophilia A bleeding

A

vWF disease: cuts and nose bleeds that bleed excessively

Hemophilia A: severe deep tissue bleeding

246
Q

Chromoblastomyces

A

look like copper pennies aka sclerotic boides/muriform cells

247
Q

erysipelas and cause

A

bright red rash w distinct borders caused by GAS

248
Q

Hot tub

A

pseudomonas

249
Q

MRSA/MSSA gene

A

mecA codes for penicillin binding site

250
Q

how is Staph a. shock diff

A

includes diarrhea and rash

251
Q

bullous impetigo

A

staph a. exclusively

252
Q

Streptolysin O and S

A

digest RBCs

-antibodies against show ASO titer

253
Q

Strep erythrogenic/pyrogenic toxin

A

causes rash of scarlet fever

254
Q

streptokinase

A

activates plasminogen and digest fibrin

255
Q

most common cause of lobar pneumonia in adults and otitis media in children

A

Strep pneumoniae

256
Q

What is associated with Strep gallolyticus/bovis

A

colon cancer so if seen order colonoscopy

257
Q

brain control of temperature

A

preoptic region of ant. hypothalamus

258
Q

treatment for malignant hyperthermia (fever caused by anesthetics)

A

dantrolene

259
Q

seretonin syndrome

A

fever caused by the administration of two or more serotonin drugs

260
Q

relapsing fever and association

A

fever spike followed by days of no symptoms followed by return of fever
-associated with malaria, babesiosis, or HODGKIN’S LYMPHOMA

261
Q

Diencephalic fits/seizures

A

fever from traumatic brain injury or hemorrhagic strokes around the hypothalamus/thalamus

262
Q

Malignant neuroleptic syndrome

A

fever caused byreaction to neuroleptic antipsychotic drugs and phenothiazine-anti-nausea meds

263
Q

Lipopolysaccharide

A

part of Gram-negative bacteria wall can cause fever, most likely mediated through other cytokines such as TNF-a and Il-1

264
Q

Pulse-temperature dissociation is associated with

A

Salmonella sp and typhoid fever

265
Q

PAMPs include

A
  • LPS on Gram-negative rods
  • lipoteichoic acid and peptidoglycan on Gram-positive organisms
  • flagellin on bacterial flagella
  • lipoarabinomannan in AFB/mycobacterial cell walls
  • mannan in the wall of fungi
  • unique bacterial and viral nucleic acids
266
Q

Pro-inflammatory mediators vs. Anti-inflammatory mediators

A

Pro-inflammatory mediators: Il-2, Il-6, Il-8, Il-10, platelet activating factor
Anti-inflammatory mediators: Il-4, Il-6, Il-10, Il-11, cortisol

267
Q

Sepsis criteria

A
  1. temp >38 (100) or <36 (96.8)
  2. HR >90 bpm
  3. Resp rate > 20 rpm or PaCO2 < 32
  4. WBC >12,000 or <4,000 or >10% band cells
268
Q

Septic shock

Refractory Septic Shock

A

Septic shock: sepsis w persisting hypotension after volume resuscitation requiring vasopressors
Refractory Septic Shock: requires more vasopressors after initial volume resuscitations and vasopressors

269
Q

qSOFA score

A
  1. BP <100 mmhg
  2. Resp rate >22
  3. altered mentation
    - 2 or more = bad outcome
270
Q

what to do w sepsis

A
  1. obtain blood cultures
  2. administer broad spectrum antibiotics
  3. measure lactate level
  4. administer 30ml/kg of ns or rl for hypotension of if lactate is >4
  5. apply vasopressors if hypotension persists after fluid resuscitation
  6. repeat lactate levels if initial was elevated
  7. use central line to measure CVP or venous O2 sat
271
Q

warm vs cold hypo dynamic shock

A

warm: high bp and low PVR
cold: low bp and high PVR

272
Q

is aspirin good w gout

A

no

273
Q

Aspirin indication

A

prophylactic against MI and recurrent transient ischemic attacks/stroke of the brain

274
Q

Aspirin pharmacology

A

acetylation of COX1 inhibiting the production of TXA2

275
Q

Aspirin effect on stomach

A

low pH in stomach 3.5 makes aspirin non polar allowing it to enter gastric mucosal cells
pH in mucosal cells is higher 7.0 trapping aspirin in cell
aspirin inhibits the production of PGE2 which is needed for the healing

276
Q

which drugs does aspirin effect

A
  • displaces warfarin inc its toxicity
  • blunts the diuretic action of furosemide and thiazides
  • reduces the K+ conserving action of spironolactone (used to dec blood pressure)
277
Q

Contraindications of aspirin

A
  • children with flu/chicken pox –> Reye’s syndrome
  • pregnancy
  • peptic ulcers
  • high doses –> G6PD def.
278
Q

Reye’s Syndrome

A

causes by giving aspirin to children that have had chicken pox and the flu

279
Q

Dipyridamole action

A

phosphodiesterase inhibitor which breaks down cAMP

  • increase cAMP
  • ↓RBC uptake of adenosine
280
Q

P2Y12 inhibitors includes

A

-“grel” or “clop”
-“or” = reversible inhibitor
Clopidogrel
Prasugrel
Ticagrelor
Cangrelor
Ticlopidine

281
Q

Clopidogrel action

A

irreversibly binds to P2Y12

PRODRUG:
1st CYP2C19
2nd CYP2C9, CYP2C19, CYP3A

282
Q

Prasugrel action

A

irreversibly binds to P2Y12

PRODRUG
1st hydrolysis
2nd CYP3A4 CYP2C19

quick acting

283
Q

Ticagrelor action and how broken down

A

Reversible inhibition of P2Y12

-broken down by CYP3A4 so avoid other drugs that use this

284
Q

Ticagrelor drug interaction

A

blocks the pump that removes digoxin from cell so increases it toxicity

285
Q

Cangrelor

A

Reversible inhibition of P2Y12

-quick acting

286
Q

Ticlopidine action, side effects, and drug interaction

A

Irreversible inhibition of P2Y12

  • side effects: neutropenia, thrombocytopenia, leukopenia
  • drug interaction: monitoring theophylline (decreased metabolism) and phentynoin (displacement of plasma proteins) plasma conc. is recommended
287
Q

Abciximab action and often use

A

antibody that binds directly to GPIIb/IIIa

  • 15 days or more in a platelet-bound state
  • bridge therapy  given with other drugs so hypercoagobility will not occur
288
Q

Eptifibatide and Tirofiban action and clearance

A
  • small fibrinogen sequences that reversibly inhibit GPIIb/IIIa
  • cleared by kidneys
289
Q

Vorapaxar action and us

A

oral selective, reversible, competitive antagonist of PAR-1 which is the activation site of thrombin
-given to patents with liver failure for the reduction of thrombotic cardiovascular events in patients with a history of MI or peripheral arterial disease (PAD)

290
Q

Unfractionated heparin action

A

used as a cofactor for antithrombin to increase break down of thrombin > Xa, IXa, XIa, XIIIa, V, VIII

291
Q

Heparin indications

A
  • venous thromboembolism in surgical and high-risk medical patients.
  • prevent blood clotting during surgery of the heart or blood vessels, during blood transfusion, in individuals with (DIC)
  • acute arterial occlusion
  • given before warfarin
292
Q

how is heparin given
what would you expect initially
clearance

A

Subcutaneous and infusion line (not IM bc cause hematoma)

-initial it will dec in blood bc it binds to endothelium and macrophage –> cleared by liver

293
Q

heparin side effects

A
  1. Heparin-induced thrombocytopenia (HIT)
  2. hyperkalemia: ↓ aldosterone synthesis resulting in the sequestion of K+
  3. osteoporosis with long term use
294
Q

what is given to reverse heparins effects

A

protamine sulfate

295
Q

Heparin resistance

A

Excessive heparin-binding proteins in plasma

Deficient antithrombin III

296
Q

heparin contraindications (5)

A
  1. asthma/history of allergy
  2. pregnancy
  3. liver impairment
  4. hypertension
  5. combined with NSAIDs
297
Q

Low molecular weight (LMW) heparins names

A

Dalteparin, enoxaparin and danaparoid

298
Q

Low molecular weight (LMW) heparins action and difference from heparin

A

stronger inhibition of Xa > thrombin

  • lower affinity to endothelial cells, macrophages and plasma proteins
  • Less frequent HIT
  • Lesser effect on aPTT
299
Q

Low molecular weight (LMW) heparins clearance

A

renal clearance

300
Q

Fondaparinux clearance

A

renal clearance

301
Q

Fondaparinux action and difference from LMWH

A

Xa&raquo_space; more than LMWH

-least likely for HIT

302
Q

Xa Inhibitors names

A

“xaban”

303
Q

Oral direct Xa Inhibitors given for

A

Prophylaxis and treatment (prevents extension) of DVT and preventing stroke in patients with AFib
-does not require monitoring

304
Q

Oral direct Xa Inhibitors indication

A

drugs that inhibit CYP3A4 and P-gp

305
Q

Direct thrombin (IIa) inhibitors names

A 
-intRUDIN and gator
Bivalirudin
Argatroban
Lepirudin
Dabigatran (oral)
306
Q

Lepirudin use and clearance

A

for pateints with HIT and liver failure

307
Q

Bivalirudin given for

A

percutaneous coronary angioplasty

308
Q

Argatroban use

A

for pattens with HIT with renal failure

309
Q

Dabigatran use and clearance

A

Oral direct Xa Inhibitor

-renally excreted

310
Q

Disseminated intravascular coagulation may occur secondary to malignant such as

A

acute promyelocytic leukemia

311
Q

what do you give patients when they cant take heparin or is having HIT

A

Direct Thrombin Inhibitors

  • Bivalirudin
  • Argatroban
  • Dabigatran (given orally)
312
Q

what to give patient with HIT and Liver failure.. Kidney failure

A

Liver failure: Dabigatran

Kidney failure: Argatroban

313
Q

Where do hairy cells collect and what does this cause

A

red pulp causing splenomegaly

314
Q

What vasssopressors to use

  1. 1st
  2. if MAP is still <65
  3. someone w severe tachycardia
A
  1. norepinephrine
  2. norepinephrine + vasopressin
  3. phenylephrine
315
Q

DGI triad and timing

A
  1. tenosynovitis
  2. polyarthritis
  3. rash of small papules that turn into tender pustules on broad erythematous bases and with necrotic centers
    - most common seen in sexual active females
    - timing: within 7 days of start of menses
316
Q

CD11c and CD25

A

hairy cell leukemia

317
Q

Warfarin action

A

Inhibits vitamin K epoxide reductase complex 1 (VKORC1)  interferes with hepatic synthesis (carboxylation) of vit K-dependent clotting factors II (prothrombin), VII, IX and X, also proteins C and S

318
Q

why is it important to bridge warfarin with heparin

A

warfarin inhibits the production of protein C which is a anticoagulant and has the shortest half life of all products warfarin inhibits via epoxide reductase
-initially hyper coagulation can occur bc of dec in protein C

319
Q

warfarin clearance and what is warfarin most potent form

A
  • liver via P450 CYP2C9

- S-warfarin is four times more potent

320
Q

warfarin indications

A
  • Prophylaxis and treatment of DVT and pulmonary thromboembolism.
  • Prophylaxis of thromboembolism associated with chronic atrial fibrillation, myocardial infarction or in individuals with prosthetic heart valves.
321
Q

warfarin contraindications

A
  • pregnancy
  • cyp mutations
  • uncontrolled HTN
322
Q

warfarin drug interactions

  1. increase toxicity
  2. decrease toxicity
  3. GI drugs that inhibit excretion
  4. impair vit K and warfarin absorption
A
  1. erythromycin
  2. rifampicin
  3. cimetidine and omeprazole
  4. colestyramine
323
Q

Thrombolytic drugs and highest affinity for fibrin bound plasminogen

A

Tenecteplase > Alteplase > Streptokinase

324
Q

Steptokinase action and problem

A

plasminogen (both clot-bound, and circulating forms)

-after initial does antibodies build up against it since it is derived from streptococci

325
Q

why is Tenecteplase the best thrombolytic drug to give

A
  • Higher fibrin-selective activation
  • Higher resistance to inhibition by PAI-1
  • Give immediately for STEMI
326
Q

Fibrinolytic inhibitors and why given

A 
Aminocaproic acid (EACA)
Tranexamic Acid (7x more potent)
-given to prevents plasmin binding to fibrin, specifically antidote for fibrinolytic agents
327
Q

Tranexamic acid

A

Binds to lysine-binding site on plasminogen and is 7x more potent than EACA

328
Q

Desmopressin

A

Causes release of vWF from platelets and endothelial lining -> increases VIII t½
-can give for mild forms of hemophilia A

329
Q

oral contraceptives effect on coagulation and who not to give to

A
  • Increased levels of factors II, VII, VIII, and X and fibrinogen
  • Do not give to patient with hemophilia A
330
Q

spondylitis vs spondylosis vs Spondylolisthesis

A

spondylitis: is inflammation of one or more vertebrae
spondylosis: degeneration of intervertebral disks

Spondylolisthesis: forward or backward displacement of the body of one vertebrae in relation to an adjacent vertebra

331
Q

greenstick fracture

A

bone bends and cracks

332
Q 
Fractures
I
II
III
IV
V
A 
SALTER
I: Straight across
II: Above
III: beLow
IV: Through
V: cRush growth plate
333
Q

koilonychia and what it means

A

flat nails seen in iron def anemia

334
Q

Fever of Unknown Origin main causes

A

-Infections: Tb, abscess, diverticulitis, cholecystitis/cholangitis
Neoplasms: lymphoma
Rheumatologic diseases: Temporal arteritis

335
Q

Familial Mediterranean Fever symptoms

A

Recurrent fever
Abdominal pain
Chest pain
Joint pain

336
Q

Cyclic Neutropenia Related Fever

A

fever due to low neutrophil count

-will subside when neutrophil count >500

337
Q

Periodic Fever with Aphthous Stomatitis, Pharyngitis and Adenitis population

A

most common fever in children

338
Q

TNF receptor-1 associated periodic syndrome (TRAPS)

A

TRAPS is in the gene that encodes the receptor for TNF (TNFR1)……leading to an excess in TNFR1 (caused by decreased shedding of the receptor, increasing receptor numbers on cells, making cells more susceptible to TNF)

339
Q

Borrelia hermsii appearance

A

small squiggly line in blood smear

340
Q

normal WBC
left shift
Neutropenia

A
  • 4,500 to 11,000
  • 25,000 to 50,000
  • 500-1000 or lower
341
Q

Toxic Granulations association

A

Associated with inflammatory conditions such as sepsis

-

342
Q

Bollus with dark red/purple exudate with bruising around

A

necrotizing fasciitis

-Bullous Cellulitis will have a more clear exudate

343
Q

Pseudo-Pleger Huet Cells association

A

myelodystplastic syndrome

-cell with two separate lobes (not connected like Pleger Huet Cells “dumbbell cells’)

344
Q

particular to rubeola

A
  • rash starting at ear and moving down
  • koplik spot
  • cough, conjunctivitis, coryza (3 C’s)
  • SSP
  • F protein
345
Q

cervical lymphenadopathy illnesses

A

EBV -> monospot/heterophile test
CMV
Rubella -> forshherimer’s spot
Acute HIV -> retro-orbital headache/history

346
Q

microcytic anemis

A 
T halassemia
A nemia of chronic disease
I ron deficiency anemia
L ead poisoning (basophilic stippling)
S iderblastic anemia
347
Q

rashes of the palms and soles

A

Variola Virus
Hand, Foot, and Mouth
Rocky Mountain Spotted Fever
Erythema multiforme

348
Q

parasites carried by dermacentor ticks

A

RMSF

Tularemia

349
Q

normal MCV

A

80-100

350
Q

aspirin messes up what drugs

A
  • furosemide, thiazide, and spironolactone

- displaces warfarin at low doses

351
Q

what patients should you not give aspirin to

A
  • children with history of flu/chicken pox = Reye’s Syndrome
  • patients with gout
352
Q

ticagrelor increases what drugs toxicity

A

increases digoxin toxicity

353
Q

Ty Cobb or ticlopidine use and you must monitor what drugs

A

irreversible PY212 that takes a 3-7 days to kick in

-theophylline and phentyrion

354
Q

Vorapaxars 1 contraindication

A

Liver failure

355
Q

22q11.2 deletion syndrome

A

digeorge syndrome

356
Q

chronic venous outflow obstruction causes

A

Liver cirrhosis

impinge on portal or splenic veins

357
Q

butcher or fisherman

A

erysipelothrix rhusiopahtiae

358
Q

chronic vs acute DIC

A

Acute DIC, associated with obstetric complications or major trauma, is dominated by a bleeding diathesis

Chronic DIC, as occurs in cancer patients, tends to present with thrombotic complications

BECOM 3 (8 decks)

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