June 9th Flashcards
Focal myocardial inflammation with multinucleate giant cells
Aschoff bodies of Rheumatic fever
Eosinophilic cytoplasmic globules near nucleus in liver
Mallory bodies of alcoholic liver disease
Desquamated epithelial casts in sputum
Kershmans spirals of bronchial asthma
Onion skin periosteal reaction
Ewing sarcoma
Psuedopalisading tumor cell arrangement
Glioblastoma
Elevated serum uric acid
Gout
Lesch Nyhan
Myeloproliferative disorders
Diuretics (Loops/TZDs)
Equation for Gibbs Free Energy
^G= ^H-T-^S
Decreased NADPH due to lack of HMP enzyme
G6PD
Inherited defect in tubular amino acid transporter
Cystinuria
Hartnup
Deficiency of homogenetisic acid oxidase
Alkaptonuria
Blocked degradation of branched chain amino acids
Maple Syrup Urine Disease
Multiple Myeloma urinalysis
Urinalysis negative
Urine protein electrophoresis shows M-spike for Bence Jones Proteins
Most common leukemia in kids
ALL
Most common leukemia in adults
CLL
Auer rods
AML M3 subtype
t(15,17)
Myelodysplastic syndromes progress to
AML blast crisis
Myeloproliferative syndromes progress to
AML
More than 20% blasts in marrow or >20% blasts in peripheral blood
Acute leukemia
Mature cells with
Chronic leukemia
Hepatosplenomegaly and lymphadenopathy
Chronic leukemia
Tdt+ acute leukemia
ALL
Bone pain
ALL/MM
Numerous basophils, splenomegaly, - LAP
CML
t(9,22) always
CML
Acute leukemia + peroxidase
AML
Solid sheets of lymphoblasts in marrow
ALL
Always associated with bcd-abl gene
CML
Smudge cells
CLL
Punched out lytic bone lesions
MM
RBCs clumped together like coins
MM
Monoclonal Ab spike
MM
MGUS
Waldenstrom macroglobulinemia
Reddish pink rods in cytoplasm of leukemic blasts
AML M3 subtype
Most cells are CD13/33+
AML
Increased risk for Downs
ALL
AML
Elderly adults
CLL
B cell markers
CLL
Autoimmune hemolytic anemia
CLL
May progress to AML
CML
Chronic myeloproliferative disorders mutation and its function
JAK2 mutation
Hematopoietic growth factor signaling
Teardrop RBCs
Myelofibrosis
Obliteration of marrow with fibroblast activity
Myelofibrosis
Translocation of AML that increases risk of downs
t(8,21)
Sx of MM
CRAB Hypercalcemia Renal insuffiency Anemia Bone lytic lesions, bone pain
Waldenstron macroglobulinemia
M spike
No lytic bone lesions
No CRAB Sx
MGUS
Monoclonal expansion of plasma cells
ASx
no CRAB
1-2% develop MM every year
Neutrophil with bilobed nuclei with thin strand connecting them
Pseudo-Pelger Heut anomaly
Seen after chemotherapy
Myelodysplastic syndromes
Solid tumor of B cells in nose
Extra medullary plasmacytoma
Vertigo, tinnitus, hearing loss
Meniere’s disease
Glaucoma Dx with
Tonometry
Fundoscopy cup:disc >2:1
Non-eveloped RNA viruses
"my Real Heavy Picture of California was Ruined without an envelope" Reovirus Hepevirus Picornavirus Calcivirus RNA No envelope
Non-enveloped DNA viruses
"PaPa and Aunt Polly Didn't have an envelope" Parvovirus Papillomavirus Adenovirus Polygomavirus DNA No envelope
Influenza recombines via
Reassortment
Live viruses considered for HIV patients
Rotovirus in all infants with HIV
VZV and MMR in patients with CD4>200
Non linear dsDNA viruses
ssRNA = parvovirus
circular DNA = polyomavirus, papillomavirus & hepadnavirus
Tx of Afib with hyperthyroid
Tx aFib with b-blockers
Tx Hyperthyroid with methamizole
Stress effects on adipocytes
Rapid breakdown of triglycerides and mobilization of fatty acids for energy
Lipase stimulation of fat cells
Multinucleate giant cells - atypical lymphocyte of EBV
Downey Cell
Where does EBV lie dormant?
B cells
Where does CMV lie dormant?
Mononuclear cells
Tx of HSV/EBV
Acyclovir
Valacyclovir
Famicyclovir
Tx of CMV
Ganciclovir
Second line tx of resistant CMV/EBV/HSV
Foscarnet
Temporal lobe encephalitis
HSV-1
Intranuclear eosinophilic droplets
Type A Cowdry bodies of HSV
Signet ring cells
Gastric adenocarinoma
Nutmeg liver
Budd-Chiari syndrome
Right sided heart failure
Maternal elevation of AFP
NTD (anencepahly, spina bifida)
Gastrochisis
Ompahacele
RBC casts in urine
Acute glomerulonephritis
Acanthocytosis of RBC and excess lipids in enterocytes
Abetalipoproteinemia
HgbA1c in Diabetic patient goal
Slapped Cheek Rash
Fifth disease
Parvo B 19
Aplastic crisis in sickle cell pt
Parvo B19
Gingovostomatitis
HSV1
Multinucleate cells on Tzanck test
HSV/VZV
Roseola
HSV 6
Milkmaid blisters
Cowpox
Vaccinia
Conjuctivitis & diarrhea
Adenovirus
Nasopharyngeal carcinoma
EBV
Oral hairy leukoplakia
EBV
Only DNA virus not double stranded
Parvovirus
Hypoglycemia, jaundice, cirrhosis
Fructose intolerance
MOA of lactulose
Digested by bacteria in colon creating an acidic environment which converts ammonia to ammonium which is then trapped in the colon and excreted in the stool
Used to lower serum ammonia in cirrhosis
Features of alkpatonuria
Being disease deficient in homogentistic acid oxidase
Dark organs, CT and urine
1 cause fatal infantile gastroenteritis
Rotavirus
Gastroenteritis on cruise ships
Norwalk virus
Common cold
Rhinovirus
Coronavirus
Fever, jaundice, black vomit
Yellow fever
Meningitis
Echovirus
Infects motor neurons of ant horn
Polio
West NIle
Break bone fever
Dengue
Torniquet test
Hemorrhagic Dengue
Opacities on X-ray on both sides of carina
Sarcoidosis
Dermatitis dementia, diarrhea, death
Pellagra
Niacin B3 deficiency
HMG CoA Reductase inhibitors
Inhibit RLS of cholesterol synthesis
Statins
Winter months
Influenza
Rotavirus
RSV
Summer months
Polio
Echovirus
Coxsackie viruses
West Nile virus
Viral meningitis
Coxsackie virus
Echovirus
Enterovirus
Mumps virus
Cough, coryza and conjunctivitis
Rubeola (Measles)
Parotiditis, orchitis, aspetic meningitis
Mumps
Animal urine
Leptospirosis
Hantavirus
Lass virus
LCM virus
Painful raised lesions on finger parts and fever
Oslers nodes of infectious endocarditis
Posterior cervical lymphadenopathy
EBV
Cat Scratch disease
Otitis media
Low serum ceruloplasmin
Wilsons
Why does a deficiency in the RLS of the HMP shunt result in hemolytic anemia?
Deficiency of G6PD results in no NADPH which is needed to reduce glutathione –> reduced glutathione is an important antioxidant in RBCs making them susceptible to hemolysis
Primary energy source who hasn’t eaten in 2 days
Fatty acids
Is the genome of HIV diploid or haploid?
RNA/DNA
Diploid RNA
What are the 3 structural genes of the HIV virus and what do they code for?
env (gp120 and gp41)
gag (p24 capsid protein)
pol (reverse transcriptase, aspartate protease and integrase) think polymerase
What is the protein that helps the HIV virus attach to CD4 T cells and what are the corecptors
Attaches to T cells with gp120
Coreceptors = CCR5 and CXCR4
On what cells and in what stage of disease are the CCR5 and CXCR4 coreceptors?
CCR5 = Macrophages and dendritic cells in early infection CXCR4 = T cells in late infection
HIV course of homozygous CCR5 mutation
immunity
HIV course of heterozygous CCR5 mutation
slower course
What does the controls fusion and entry?
gp41
What controls attachment to T cells
gp120
What is the capsized protein?
p24
What does pol code for?
Reverse transcriptate
Integrase
Aspartate protease
Function of reverse trasnscriptase
synthesizes sDNA from genomic RNA allows for sDNA integration into the host genome
CD4
TMP-SMX for PCP
Dapsone if sulfa allergy
Pentamidine (aerosolized) if G6PD
CD4
TMP-SMX for Toxoplasma & PCP
Dapsone + Pentamidine + Leucovorin if sulfa allergy
CD4
Azithromycin for MAC/MAI
Most common cause of DIC
"STOP Making Thrombi" Sepsis Trauma Obstetric complications Pancreatitis Malignancy Transfusion
Most common heart murmur
MVP
Most common coronary artery involved in thrombus
LAD
Most common cause of death in lupus
Renal failure due to lupus nephritis
Most common congenital heart anomaly
VSD
Clinical Sx and Cause of Addisons Disease
Skin hyper pigmentation Hypotension Malaise Weakness Weight loss Anorexia Autoimmune destruction of adrenal glands >> adrenal atrophy >> decreased cortisol and aldosterone
MOA: inhibit influenza neuroaminidase decreasing release of progeny virus
Oseltamivir
Zanamivir
Cherry red spot on macula
Tay-Sachs
Neiman Pick
Central artery occlusion
Facial muscle spasm with tapped cheek indicates
Hypocalcemia
Chovstek sign
What regulates prolactin secretion?
TRH stimulates
Dopamine and Prolactin inhibit
AIDS pt with meningitis
Cryptococcus neoformans
India ink stain
Crytpococcus
Soap bubble lesion in brain
Cryptococcus
Sabouraud agar
Cryptococcus
Diffuse interstitial pneumonia with diffuse bilateral ground glass opacities with disc shaped yeast
Pneumocysitis jirovecii
Disc shaped yeast on silver stain
Pneumocysitis jirovecii
Cryptococcus prophylaxis
Fluconazole
Tx for oral candidiasis
Nystain
Fluconazole
Tx for systemic candidiasis
Fluconazole
Amphoteracin B
Most common opportunistic infxn in AIDS puts
Pneumocystis
Spaghetti and meatballs
Tinea versicolor
Malassezia furfur
Frontal lobe abscess
Mucor
Broad irregular shaped nonseptae hyphae branch at 90 degrees (wide)
Mucor
Narrow septated hypae branch at 45 degrees
Aspergillus
Fungus ball
Aspergilloma
Intertrigo
Candida under breast or in skin folds of obese patient
Jagged diaper rash with satellite lesions
Candida
Germ tube small projects in blood draw tube
Candida
Lens shaped lesion on head CT
Epidural
Pigmented hamartomas in iris
Lisch nodules of Neurofibromatosis
No milk production postpartum
Sheehan syndrome
Howell jolly bodies
Asplenic DNA remnants
Cancer associated with asbestosis
Mesthelioma
Bronchogenic carcinoma
Owl’s eye inclusions
CMV
Owl’s eye nucleus
Reed Sternberg cells of Hodgkin lymphoma
Owl’s eye protozoa
Giardia
Enzyme deficient in PKU and Sx
Phenylalanin hydroxylase Musty odor Mental/growth retardation Ezcema Fair skin Seizures
Organisms associated with birds
Histoplasma Cryptococcus Chlamydophila psittaci H5N1 West Nile Virus