Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Step Random Tidbits > First Aid 173-196 > Flashcards

First Aid 173-196 Flashcards

1
Q

Why administer imipenem with cilastin?

A

Cilastin inhibits renal dehydropeptidase I which would otherwise inactivate imipenem in the renal tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Aztreonam clinical use

A

Gram negative rods only;

Use in penicillin allergic patients or patients who cannot handle the nephrotoxicity of aminoglycosides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q 
Gentamicin;
Neomycin;
Amikacin;
Tobramycin;
Streptomycin;
What drug class?
A

Aminoglycosides;
Ototoxicity (esp when used with loop diuretics);
Severe gram neg infections;
Require oxygen for uptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Minocycline - what drug class?

A

Tetracycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why do infants get “gray baby syndrome” with chloramphenicol use?

A

They lack liver UDP-glucuronyl transferase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Use what for anaerobes above the diaphragm?

A

Clindamycin (and Metronidazole for anaerobes below the diaphragm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Use Linezolid for:

A

Gram positives like MRSA and VRE;
Binds 50S
SE: thrombocytopenia, peripheral neuropathy, serotonin syndrome, optic neuritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When to use dapsone, when not to use dapsone

A

Use dapsone for MRSA if patient is allergic to vancomycin;
Do not use dapsone for pneumonia bc it is inactivated by surfactant;
SE: rhabdomyloysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MOA Ethambutol

A

Anti-cell wall - mycobacteria;

Inhibits Arabinosyl transferase –> No arabinoglycan synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MOA Isoniazid

A

Anti-cell wall - mycobacteria;

Inhibits mycolic acid synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is rifabutin preferred over rifampin for use in HIV-infected patients?

A

Rifabutin has less cytochrome P-450 induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How is isoniazid activated in the body?

A

By bacterial catalase-peroxidase (encoded by KatG)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Use for Streptogramin class - Quinupristin, Dalfopristin

A

VRE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Use for tigecycline

A

MRSA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The azole class inhibits what enzyme in the formation of fungal cell membranes?

A

14-alpha-demethylase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Use: Nifurtimox

A

Chagas disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MOA Chloroquine

A

Blocks detoxification of heme to hemozoin –> build up of heme is toxic to plasmodia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Function of RBC receptors CD55 and CD59

A

Prevent MAC from attacking RBCs;

CD55 missing in PNH because no glycan anchoring protein made (GPI) –> lysis and release of free hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Recurrent infections that worsen with age;
Easy bleeding;
Eczema;
Dx?

A

Wiskott-Aldrich Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Recurrent Neisseria infection;

Dx?

A

Terminal complement deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Severe bacterial and viral infections in infancy;
Chronic diarrhea;
Mucocutaneous candidiasis;
Dx?

A

Severe combined immunodeficiency

very low or absent CD3+ T-cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Congenital heart disease;
Dysmorphic facies;
Hypocalcemia;
Dx?

A

DiGeorge syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Severe bacterial and fungal infections;
Granuloma formation;
Dx?

A

Chronic granulomatous disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Oculocutaneous albinism;
Pyogenic infections;
Progressive neurologic dysfunction;
Dx?

A

Chediak-Higashi syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CVID is similar to SCID but

A

no thymic aplasia;

infections present after infancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Immunohistochemistry staining of the complete moles is p-57 negative due to

A

absence of a maternal genome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

The type of mutation in fragile X syndrome

A

Loss of function mutation;
Long arm of X chromosome;
FMR1 (fragile X mental retardation) gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Tetanospasmin is what kind of toxin?

A

Exotoxin;

Prevents release of glycine and GABA from spinal inhibitory interneurons that regulate LMNs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Dolutgravir
Raltegravir
Elvitegravir
Class? SE?

A

HIV Integrase inhibitors

SE: increase in creatine kinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Acyclovir, Famciclovir, Valacyclovir are analogs of

A

guanosine

So is Ganciclovir (for CMV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Main SE of ganciclovir/valganciclovir

A

Bone marrow suppression

Renal toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Pyrophosphate analog that is both HIV RT inhibitor and DNA/RNA polymerase inhibitor

A

Foscarnet - like Cidofovir, does not require phosphorylation by viral thymidine kinase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Coadminister what antiviral with probenecid an IV saline to reduce nephrotoxicity

A

Cidifovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the usual HIV tx cocktail?

A

2 NRTIs and 1 integrase inhibitor (standard)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the only NRTI that is already a nucleotide and therefore need not be phosphorylated to activate?

A

Tenofovir

36
Q

What can be administered to reverse the bone marrow suppression associated with NRTI therapy?

A

G-CSF (granulocyte colony-stimulating factor) and EPO

37
Q

What NNRTIs are contraindicated in pregnancy?

A

Delavirdine

Efavirenz - associated with CNS symptoms and vivd dreams

38
Q

What NRTI has a SE of pancreatitis?

A

Didanosine

39
Q

What is the difference between NRTIs and NNRTIs?

A

The NNRTIs bind RT at a different site and do not need to be phosphorylated

40
Q

What HIV protease inhibitor is also a CYP450 inhibitor?

A

Ritonavir

41
Q

What HIV treatment class is associated with lipodystrophy?

A

Protease inhibitors (-navir)
result in Cushing-like fat redistribution
Hyperglycemia is another SE

42
Q

What potent CYP/UGT inducer is contraindicated with HIV protease inhibitors?

A

Rifampin

43
Q

What interferon treats:

Multiple sclerosis

A

IFN-beta

44
Q

What interferon treats:

CGD

A

IFN-gamma

45
Q

What interferon treats:

chronic hep B and C, Kaposi sarcoma, hairy cell leukemia, condyloma acuminatum, renal cell carcinoma, malignant melanoma

A

IFN-alpha

46
Q

What Hep C therapy inhibits synthesis of guanine nucleotides?

A

Ribavarin
severe teratogen
SE hemolytic anemia
inhibits inosine MP dehydrogenase

47
Q

MOA Sofosbuvir

A

inhibits HCC RNA-dependent RNA pol
acts as a chain terminator
must use in combination with ribavarin +/- peginterferon-alpha

48
Q

MOA Simprevir

A

HCV protease inhibitor

must use with Ledipasvir (NS5A inhibitor)

49
Q

What infection control techniques can be sporocidal?

A

Autoclave
H2O2
Iodine and iodophors

50
Q

“SAFe Children Take Really Good Care”

A 
Antimicrobials to avoid in pregnancy:
Sulfonamides - kernicterus
Aminoglycosides - Ototoxic
Fluoroquinolones - Cartilage damage
Clarithromycin - Embryotoxic
Tetracyclines - discolored teeth and inhibition of bone growth
Ribavarin
Griseofulvin
Chloramphenicol - gray baby syndrome
51
Q

Medullary sinuses of lymph nodes contain

A

reticular cells and macrophages;

they interact with efferent lymphatics

52
Q

Where are T cells found in the lymph node?

A

Paracortex
Between follicles and medulla;
not well developed in patients with DiGeorge syndrome;
enlarges in extreme cellular immune response ie viral infection

53
Q

The superior mesenteric lymph node drains

A

lower duodenum, jejunum, ileum, colon to splenic flexure

54
Q

The para-aortic lymph node drains

A

testes, ovaries, kidneys, uterus

55
Q

The vagina (middle third) and cervix are drained by

A

Internal iliac lymph node

Vulva - superficial inguinal

56
Q

Right lymphatic duct drains everything from where?

A

on the right side of the body above the diaphragm

57
Q

The thoracic duct drains everything on the left side of the body, and the right side of the body below the diaphragm, into where?

A

the junction of the left subclavian and internal jugular veins

58
Q

Where are T-cells found in the spleen?

A

Periarteriolar lymphatic sheath (PALS) within the white pulp;
B cells are found in the follicles of the white pulp

59
Q

What is the function of the marginal zone of the spleen?

A

APCs capture blood-borne antigens for recognition by lymphocytes;
contains macrophages and specialized B cells;
Marginal zone between red and white pulp

60
Q

What are the effects of lowered IgM levels in splenic dysfunction (or absence)

A 
low IgM --> low complement activation --> low C3b opsonization --> increased susceptibility to encapsulated organisms:
Pseudomonas
Strep pneumo
Haemophilus
Neisseria
E Coli
Salmonella
Kelbsiella
Group B strep
61
Q

The thymus is derived from the:

A

third pharyngeal pouch

“Th”ymus - “th”ird

62
Q

Of what embryological origin are lymphocytes?

A

Mesenchymal

63
Q

Lyzozyme, complement, C-reactive protein and defensins are all what?

A

proteins secreted by the innate immune system

64
Q

Examples of PAMPS recognized by TLRs

A

LPS of gram negative bacteria;
Flagellin;
Viral nucleic acids

65
Q

MHC is encoded by

A

HLA genes;

MHC presents antigen fragments to T cells and binds T-cell receptors

66
Q

HLA-A
HLA-B
HLA-C
are

A

MHC I (one letter)

67
Q

HLA-DR
HLA-DP
HLA-DQ
are

A

MHC II (2 letters)

68
Q

MHC I is expressed on all nucleated cells except

A

RBCs

69
Q

Where is MHC II expressed?

A

Surfaces of APCs

70
Q

Where are MHC I antigen peptides loaded?

A

RER - then transported to membrane

71
Q

How are MHC II antigen peptides loaded?

A

After endocytosies –> endosome –> release of invariant chain in an acidified endosome –> back to surface

72
Q

MHC I has what associated protein?

A

Beta-2-microglobulin

73
Q

“PAIR” for HLA-B27

A 
Psoriatic arthritis
Ankylosing spondylitis
IBD-associated arthritis
Reactive arthritis
aka the seronegative arthropathies
74
Q

What is the only lymphocyte-derived member of the innate immune system?

A

NK cells

use perforin and granzymes to induce apoptosis of virally infected and tumor cells

75
Q

IL-2, IL-12, IFN-alpha and IFN-beta enhance the activity of

A

NK cells

76
Q

How are NK cells activated? 3 ways…

A
  1. Absence of MHC I on a cell
  2. Exposure to a nonspecific activation signal on a target cell
  3. Also kill via antibody-dependent cell-mediated cytotoxicity where CD16 binds Fc region of bound Ig
77
Q

B cella become what to secrete immunoglobulins?

A

plasma cells

78
Q

T-cells are involved in what hypersensitivity reaction?

A

type IV - delayed cell-mediated

79
Q

What is positive selection?

A

Thymic cortex;

Can T cells bind self?

80
Q

What is negative selection?

A

Thymic medulla

Too high self-affinity gets destroyed

81
Q

AIRE deficiency leads to

A

Polyendocrine syndrome I

82
Q

APCs are:

A

B cells, macrophages, dendritic cells

83
Q

B7 proteins on APCs that make up the costimulatory signal have what CD?

A

CD80/86

Interacts with CD28 on naive T cell

84
Q

CD40 receptor on B cell binds

A

CD40L on Th cell –> cytokine release determines class switching, ab production/maturation

85
Q

Fc part of ab binds

A

complement and macrophages

F”c” for complement, carboxy terminal, constant, carbohydrate side chains

Step Random Tidbits (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions