First Aid 101-124 Flashcards
Fruity odor in ketoacidosis is caused by
acetoacetate in blood –> acetone –> breathed out
What enzyme matures nascent HDL to mature HDL?
LCAT - lethicin-cholesterol acetyltransferase
CETP - cholesterol ester transfer protein then transfers cholesterol esters to VLDL, IDL, LDL
Function of apolipoprotein E
Mediates remnant uptake
in everything but LDL
Function of apolipoprotein A1
Activates LCAT
only in chylomicrons and HDL
Function of apolipoprotein C-II
Lipoprotein lipase cofactor In VLDL (to make IDL), chylomicrons, HDL
Function of apolipoprotein B-48
Mediates chylomicron secretion
In chylomicrons and chylomicron remnants
Function of apolipoprotein B-100
Binds LDL receptor
In VLDL, IDL, LDL
In general, all lipases degrade
triglycerides
LDL transports cholesterol from
liver to tissue
HDL transports cholesterol from
periphery to liver;
acts as repository for apolipoproteins C and E
alcohol increases HDL synthesis;
secreted from both liver and intestine
AR pancreatitis hepatosplenomegaly, no increased risk of atherosclerosis eruptive/pruritic xanthomas
Type I familial dyslipidemia - hyperchylomicronemia
deficiency in either LPL (VLDL –> IDL and chylomicrons –> chylomicron remnants) or C-II (LPL cofactor)
increased cholesterol, TG, chylomicrons in blood
AD
corneal arcus
can have MI before age 20
familial hypercholesterolemia (type II familial dyslipidemia); absent or defective LDL receptors; accelerated atherosclerosis
high blood levels of LDL and cholesterol
AD
hypertriglyceridemia can cause pancreatitis
type IV familial dyslipidemia - hypertriglyceridemia;
hepatic overproduction of VLDL
high blood levels of TG and VLDL
Function of MTP - microsomal triglyceride transfer protein
chaperone for apo B and helps with lipid transfer to new chylomicrons and VLDL;
defective in Abetalipoproteinemia (AR)
very low VLDL, chylomicrons, absent apoB –> poor lipid absorption, acanthocyte RBCs, vitamin deficiencies (E bc no essential FAs absorbed), progressive ataxia, retinitis pigmentosa, enterocytes with clear, foamy cytoplasm
acanthocyte RBCs, vitamin deficiencies (E bc no essential FAs absorbed), progressive ataxia, retinitis pigmentosa, enterocytes with clear, foamy cytoplasm
Abetalipoproteinemia (AR)
loss of MTP fx or gene
Lipoteichoic acid unique to
gram positive organisms
induces TNF and IL-1
What parts of the cell’s exterior are unique to gram negative organisms?
Porin in cell wall;
Endotoxin/LPSs on cell wall exterior (antigenic outer membrane proteins “OMPs”);
Periplasmic space in between thin peptidoglycan cell wall and inner cell membrane - where beta-lactamase is found
Gram negative sphere besides Neisseria
Moraxella catarrhalis
Give 3 examples of Giemsa staining organisms
Chlamydiae Ricketssiae Borrelia Trypanosoma (NOT treponema) Plasmodium
Legionella, Rickettsia, Chlamydia, Bartonella, Ehrlichia, Anaplasma, have in common?
Primarily intracellular
Chlamydia lack classic peptidoglycan because low in muramic acid (mermaid)
India ink or mucicarmine stain for
Cryptococcus neoformans
3 other organisms that silver stain identifies besides legionella
Coccidiodes, PJP, Heliobacter pylori
“Very Typically Cultures Neisseria”
Thayer-Martin agar - selective media
Vancomycin, Trimethoprim, Colistin, Nystatin
“Bordet for Bordetella”
Bordet-Gengou agar
Rean Lowe medium
for Bordatella pertussis isolation
Loffler medium for
C. diphtheriae (also Tellurite)
Eaton agar for Mycoplasma requires
cholesterol
Lowenstein-Jensen agar for
M. tuberculosis
Legionella requires charcoal yeast extract buffered with
cysteine and iron
Sabouraud agar for
fungi
What antibiotics are ineffective against anaerobes because they require O2 to enter the bacterial cell/
Aminoglycosides
“Some Nasty Bugs May Live FacultativeLY”
Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia pestis
LPS induces what three effects?
Macrophage activation (TLR4)
- -> IL-1, IL-6 –> fever
- -> TNF-alpha –> fever, hypotension
- -> NO –> hypotension
Complement activation
- -> C3a –> histamine release, hypotension and edema
- -> C5a –> neutrophil chemotaxis
Tissue factor activation
–> coagulation cascade –> DIC
Pyrrolidonly arylaminidase (PYR) positive
Strep pyogenes
Enterococcus
Fidaxomicin for
recurrent C. Diff
Elek test to identify
toxin in diphtheriae
black colonies on cystine-tellurite agar
Treatment for Actinomyces
Penicillin
Treatment for Nocardia
TMP-SMX
Azithromycin prophylaxis in AIDS patients with CD4
Mycobacterium avium-intracellulare
H2S production on TSI agar
Salmonella
Proteus
What is the key defining cell of granulomatous inflammation?
Epitheloid histiocyte (macrophages with abundant pink cytoplasm)
What is the histologic hallmark of Crohn disease?
Non-caseating granuloma
What is the histologic hallmark of Ulcerative Colitis?
Crypt abscesses - neutrophils in the bottom of crypts
Most common type of thyroid carcinoma
Papillary carcinoma
Second most common thyroid cancer
Follicular carcinoma
Thyroid carcinomas that involve activation of receptor tyrosine kinases
Papillary and medullary carcinomas
RET proto-oncogene
Hashimoto thyroiditis is a risk factor for
B cell lymphoma
Cancer arising from parafollicular C cells
Medullary carcinoma
Cancer commonly associated with either a RAS mutation or a PAX8-PPAR gamma 1 rearrangement
Follicular carcinoma
Cancer commonly associated with rearrangements in the RET oncogene or NTRK1
Papillary carcinoma
Most common mutation in the BRAF gene results in
Papillary carcinoma
MOA Propothoiuracil
Inhibits peripheral conversion of T4 to T3;
inhibits thyroglobulin to diiodotyrosine in the follicle
NOTE: PTU and Methimazole can both cause aplastic anemia
What cholesterol labs are elevated in hypothyroidism?
LDL and total cholesterol
