Feb 19th

Question 1

What causes the pseudomembranous colitis found in C. Difficile?

Answer 1

• Actin depolymerization by exotoxin B.
• leads to necrosis and death and eventually the yellow gray exudate that is the membrane.
• AKA cytotoxin

Question 2

What are Meissener Corpuscles?

Answer 2

- Sensory receptors found in HAIRLESS areas of body 
Light touch 
fine touch
Dynamic 
Positional sense

Question 3

Where Are Meissner corpuscles found?

Answer 3

Immediately below the epidermis

• Genitalia
• Palms of hands
• Soles of feet
• Eyelids
• Lips
• Fingertips

Question 4

What is the mnemonic for the epidermal layers of skin?

Answer 4

Californians Like girls in String Bikinis

Question 5

What layer of the common 5 is typically only found in the palms and soles of feet?

Answer 5

Lucidum

- Luke has thick skin and thus he has an extra layer

Question 6

Where do testes drain their lymph? What else drains here?

Answer 6

Para-aortic

- Kidneys, uterus, ovaries

Question 7

Where does the scrotum drain its lymph? What else goes here?

Answer 7

Superficial inguinal

• Skin below umbilicus (except popliteal)
• Anus below pectinate line
• vulva

Question 8

Where does lymph in the popliteal LN get its drainage from?

Answer 8

Dorsolateral foot

Posterior calf

Question 9

If we were to have a venous ulcer that got infected where would the enlarged LN’s be? how about arterial?

Answer 9

Venous would be Superficial inguinal

Arterial would be popliteal

Question 10

What is the MOA of Bacitracin?

Answer 10

Peptidoglycan synthesis inhibitor

- inhibits the carrier of peptidoglycan building blocks

Question 11

Why is Bacitracin only used topically?

Answer 11

Extremely nephrotoxic

Question 12

What is the MOA of Daptomycin?

Answer 12

Lipopeptide that disrupts cell membrane of Gram + organisms

• loss of membrane potential
• this causes them to be unable to continue with nucleotide synthesis

Question 13

What are the uses of Daptomycin? Not used for?

Answer 13

MRSA, bacteremia, Endocarditis and VRE

- Not used for Pneumonia because it is inhibited by surfactant

Question 14

What is the treatment for RSV?

Answer 14

Ribavirin

Question 15

What is the MOA of Ribavirin?

Answer 15

Inhibits Inosine Monophosphate dehydrogenase

• IMP–> GMP
• Thus inhibits the production of Guanine

Question 16

What are the SE of Ribavirin?

Answer 16

Hemolytic anemia

Severe teratogen

Question 17

What is the MOA of acyclovir? Famciclovir and valacyclovir?

Answer 17

Guanosine analog

• Activated (phosphorylated by viral Thymidine kinase)
• Thus few adverse affects
• Causes chain termination and inhibitors viral DNA synthesis

Question 18

What is the disease called from S. mansoni?

Answer 18

Katayama fever

Question 19

When should you suspect Katayama fever?

Answer 19

Healthy person who traveled to South A, Sub Saharan Africa, Middle east who presents with:
Fever
Hepatosplenomegaly
Peripheral eosinophilia

Question 20

What is the classic triad for Job syndrome?

Answer 20

1. Staph infections abscesses
2. Elevated IgE
3. Pruritic Eczema

Question 21

What is the mutation and inheritance of Job syndrome?

Answer 21

Deficient Th17 cells due to STAT3 TF mutation

- Autosomal dominant

Question 22

What is decreased in Job syndrome? What is another name for it?

Answer 22

INF-y decrease
IgE increased
- Autosomal dominant hyper-IgE syndrome

Question 23

What are the inferior leads?

Answer 23

II, III and avF

Question 24

What does the posterior descending artery supply?

Answer 24

Posterior 1/3 of interventricular septum

Inferior and posterior ventricles

Question 25

What supplies the SA and AV node?

Answer 25

RCA

Question 26

How do Jahovah’s witnesses children rule in terms of needed blood?

Answer 26

Religious reasons for blood transfusions can be denied by the parents for themselves

• However they cannot deny the child of a needed blood transfusion
• Medical ethics state and local courts will rule in this manner