General 2 Flashcards
What is assc. w/ leukoplakia besides EBV (secondary to HIV)?
Tobacco use
Can’t be scraped off unlike oral thrush
What should you think about when there’s oral thrush w/out any other complains (like dentures, DM, immunosuppression)?
HIV -> b/c this is how it commonly presents
First study found significant reduction in RR w/ good p vale. Second study found no significant reduction b/c they got the same RR but w/ bad p value. What’s the problem?
Sample size is!
Don’t think of p value as being the indicator of only type I error
The second study has type II error b/c they found no difference when difference truly exists, so this is related to power of the study, which is related to sample size
What kinds of transplant should you be thinking about GVHD instead of acute rejection?
BM, liver (or any other organ rich in lymphocytes), transfusion of non-irradiated blood
You’ll also see manifestations in skin, liver, GI tract outside of what’s transplanted in GVHD (vs. just infiltrates in graft vessels in acute rejection)
Both GVHD and acute rejection are mediated by T cells and develop at about 1 wk tho
What does it mean that genetic code is degenerate?
There are more codons than AAs
What are P bodies?
Foci w/in cytoplasm that serves in repression/decay of mRNA as well as mRNA storage
2 enzymes involved in methylguanosine capping at 5’ end? Why does this step matter?
Guanylyltransferase: adds guanine triphosphate to 5’
Guanine-7-methyltransferase: methylation of guanosine cap
This process protects mRNA from degradation by cellular exonucleases and allows it to exit nucleus
What is the eukaryotic equivalence of PABA?
Folic acid
Which protein synthesized by HIV needs to be glycosylated and cleaved into 2 smaller proteins in ER and golgi?
gp160 from env gene -> cleaved intto gp120 and gp41
How does HIV infection of CD4+ T cells cause cell damage?
Direct cytopathic effect
5 class of antibiotics that tx pseudomonas?
Penicillins: ticarcillin, piperacillin
Caphalosporins: ceftazidime (3rd gen), cefepime (4th gen)
Aminoglycosides
Fluoroquinolones: ciprofloxacin, levofloxacin
Carbapenems: imipenem, meropenem
What does TGF-B induce isotype switching to?
IgA
What Ig is best at complement fixation? What about opsonization of bacterial toxin?
Complement: IgM
Opsonization of bacterial toxins: IgG
What does it tell you when neoplasm expresses CD31?
CD31 = PECAM1 -> tells you that it’s endothelial origin
What are the 2 characteristics of drugs w/ high intrinsic hepatic clearance?
High lipophilicity
High Vd
What are the 3 characteristics of drugs that tend to be excreted unchanged in urine?
Low Vd
Highly plasma PB
Hydrophilic
2 molecules in death receptor pathway?
Type 1 TNF receptor
Fas (CD95)
What can minors consent to in most states w/out parental consent?
Prenatal care (but CAN’T consent to abortion in most states)
STDs
Contraception
Drug/alcohol rehabilitation
Diff steps of protein translation and antibiotics that target them?
Order pretty much goes w/ mnemonics buy AT 30, CCEL at 50.
Formation of initiation complex: aminoglycosides (30S)
Binding of aminoacyl-tRNA to A site: tetracyclines (30S)
Peptidyltransferase enzyme: chloramphenicol (50S)
Translocation: clindamycin and erythromycin (50S)
What do A, P, and E sites do on ribosome complex?
P site: binds starting AA (methionine)
A site: binds incoming aminoacyl-tRNA -> AA from P site gets transferred over to A site
E site: empty tRNA gets shifted here from P site
3 most common bacterial causes of acute otitis media, sinusitis, and bacterial conjunctivitis in childhood?
- Strep pneumo
- Nontypable H. influenzae (DON’T produce capsule -> the one that does causes meningitis)
- Moraxella catarrhalis
Why is histone H1 special?
The only one outside the nucleosome core -> helps package nucleosomes into more compact structures by linking DNA bet. adjacent nucleosomes
Steps of PI3K/Akt/mTOR pathway?
growth factor binds receptor tyrosine kinase -> PI3K activated -> PIP2 in plasma membrane turned to PIP3 -> PIP3 activates Akt (protein kinase B, serine/threonine-specific protein kinase) -> mTOR activated and translocated into nucleus to induce gene expression (promotes survival)
What’s the effector of JAK/STAT pathway?
STAT dimerize and translocate to nucleus
Major adaptive immune mechanism that prevents reinfection w/ influenza virus?
IgG against hemagglutinin in circulation
IgA against hemagglutinin in nasopharynx
NOT T cell response or anything like that
Best antibiotics for anaerobes above diaphragm (like lung abscess)? Below diaphragm?
Above diaphragm: clindamycin b/c it covers both anaerobic and aerobic
Below diaphragm: metronidazole (only covers anaerobic)
Which org has peritrichous flagella?
Proteus mirabilis -> highly motile (so flagella uniformly distributed over entire surface of cell)
What other sign signifies irreversible cell damage besides membrane lysis?
Vacuoles in mitochondria (implies permanent inability to generate ATP)
NOT mito swelling, which is reversible
What’s the effector of PLC pathway?
Protein kinase C
Activated by DAG and Ca2+ (which is released under IP3 influence)
Was told the % of absolute risk in standard tx and that FDA would only approve a new drug if it decreases the risk by a certain % compared to standard tx. How do you calculate % absolute risk of new tx?
Just take the percentage that FDA will accept and multiply it to %AR of standard tx
Ie. standard tx’s recurrent rate is 8%, FDA will only approve if new drug decreases the rate of recurrence by at least 40% -> so just take 60% of 8% -> meaning FDA will approve a new drug if the maximal rate of recurrence is 4.8%
More proper way to do it is RRR = (ARcontrol - ARtx) / ARcontrol
Plug in RRR = 0.4, ARcontrol = 0.08 and solve for ARtx
What’s the problem w/ RRR?
Overestimate effectiveness of intervention
RRR of 50% occurs whether a drug decreases incidence from 2% to 1% or from 50% to 25%
What molecule from N. meningitidis correlates w/ morbidity and mortality? What molec correlates w/ immunogenicity?
Morbidity and mortality: look at LOS (it’s like LPS but lacks repeating O-Ag) -> this is what causes sepsis, petechiae, Waterhouse-Friderichsen
Immunogenicity: capsular polysaccharide -> generates protective Ab (but remember that there’s no vaccine for B serotype)
Life cycle of strongyloidiasis? What’s the complication?
Laevae penetrate skin (might see larva currens on thigh and buttocks) -> migrate hematogenously to lungs -> go up pharynx and swallowed -> lay eggs which hatch in intestinal mucosa -> so dx is seeing rhabditiform (noninfectious) LARVAE in stool
B/c of autoinfection, worm burden might cause hyperinfection and septic shock
What is the mechanism that generates infectious virus from 2 noninfectious viruses that don’t have segmented genomes? What about segmented genomes?
Non-segmented genomes: recombination (crossing over w/in homologous regions)
Segmented genomes: reassortment
Triad of congenital toxoplasmosis? How do you dx?
Chorioretinitis, hydrocephalus, intracranial calcification
Serology, bx (tachyzoite)
Nematodes that you get from ingestion?
“you’ll get sick if you EAT these!”
Enterobius (pinworm), Ascaris (giant roundworm), Toxocara (visceral larva migrans from dogs and cats)
Nematodes that penetrate your skin?
“these get into your feet from the SANd”
Strongyloides (threadworm), Ancylostoma (hookworms), Necator (hookworms)
Nematodes that you get from bites?
"lay LOW to avoid getting bitten" Loa loa (deer fly, horse fly, mango fly), Onchocera volvulus (female blackfly bite, river blindness), Wuchereria bancrofti (female mosquito, elephantitis)
What 4 orgs cause food poisoning assc. w/ exotoxin formed AFTER ingestion?
ETEC and cholera
EHEC and Shigella
Lipid A is present on LPS outer membrane of what group of orgs? What does it do?
All Enterobacteriaceae
For acivation of macrophages -> cytokines causing septic shock
What organisms show up green on EMB agar?
Anything fermenting lactose -> like E. coli
O Ag is on the outer membrane of what group of orgs?
G- -> EXCEPT neisseria spp
Used to classify G-
What is the increase in glycogenolysis assc. w/ muscle contraction mediated by?
Increase in cytoplasmic Ca2+!!! -> phosphorylates stuff and activates them
cAMP promotes glycolysis too but it’s not assc. w/ muscle contraction (just flight or fight response)
What gives rise to mammary glands and epidermis?
Surface ectoderm
Mammary glads are just modified sweat glands so consider them epidermis appendages
What gives rise to adenohypophysis?
Surface ectoderm
Best way to prevent neonatal tetannus?
Maternal vaccination (w/ tetanus toxoid) during pregnancy -> transfer of IgG antitoxin across placenta
What monosaccharide has the fastest rate of metab in glycolysis?
Fructose (enters glycolysis as G3P so bypass PFK-1 which is a major regulatory step)
What do diff monosaccharides enter glycolysis as?
Galactose: enters as glu 6-P
Mannose: enters as fruc 6-P
Fructose: enters as G3P
3 drugs that tx C. diff and when to use them?
First mild-moderate attack: metronidazole
First severe attack or recurrent: oral vancomycin (bacteriostatic)
Recurrent colitis or increased risk of recurrence: fidaxomicin
Patchy areas of skin anesthesia and hypopigmentation + bacteria invading Schwann cells. What’s the org?
Mycobacterim leprae (clinical manifestations depend on Th1 immune response)
What bac has PRP (polyribitol ribose phosphate)?
H. influenzae B -> part of its capsule (vaccine targets this)
What is “malignant pustule” and what causes it?
Painless ulcer w/ black eschar and local edema
B. anthracis
What do you use to stain Giardia cysts in stool?
Iodine