Micro/Path Flashcards
1
Q
From the following list select THREE items associated with Hep C
picorna ssRNA oral-anal flavivirus dsDNA hepadna blood borne vaccination available
A
ssRNA
flavi
blood borne
cure available
2
Q
From the following list select items associated with Hep A
picorna ssRNA oral-anal flavivirus dsDNA hepadna blood borne vaccination available
A
picorna
ssRNA
oral anal
vaccine available
3
Q
From the following list select items associated with Hep B
picorna ssRNA oral-anal flavivirus dsDNA hepadna blood borne vaccination available
A
hepadna
dsDNA
blood borne
vaccination available
no cure
4
Q
From the following list select items associated with Hep D
picorna ssRNA oral-anal flavivirus dsDNA hepadna blood borne vaccination available
A
ssRNA
blood borne
deltavirus
only coinfx w B
5
Q
From the following list select items associated with Hep E
picorna ssRNA oral-anal flavivirus dsDNA hepadna blood borne vaccination available
A
ssRNA
oral anal
calicivirus
endemic kinda
6
Q
flu virus:
family, genome, transmission
A
orthomyxo
ssRNA
respiratory droplets
7
Q
respiratory syncytial virus:
family genome transmission
A
paramyxo ssRNA respiratory
bronchiolitis and pneumonia in infants
8
Q
measles
family genome transmission
A
paramyxo, ssRNA, respiratory
measles = rubeola
9
Q
mumps
family genome transmission
A
paramyxo, ssRNA, respiratory
mumps
10
Q
rubella
family genome transmission
A
toga, ssRNA, respiratory
rubella (german measles)
11
Q
adenovirus
A
adeno, dsDNA, respiratory
pharyngitis, conjunctivitis, pneumonia
12
Q
rhinovirus
A
picorna (LIKE HEP A!), ssRNA, respiratory
common cold
13
Q
HIV
A
retro, ssRNA, blood borne and genital
AIDS
14
Q
CMV
A
herpesvirus, dsDNA, respiratory
mono
15
Q
EBV
A
herpes, dsDNA, respiratory
infx mono
16
Q
HSV1
A
herpes, dsDNA, oral
gongovostomatitis, herpes labialis
17
Q
HSV2
A
herpes, dsDNA, genital (STD)
genital herpes
18
Q
Rotaviruses are most common cause of gastroenteritis in children under 2.
Reoviruses have an icosahedral capsid composed of outer and inner protein shell with double-stranded segmented genome.
A
both true
reo: no envelope; icosahedral capsid; ds segmented RNA
have RNAdRNApol, replicate in c/pl
members of family:
rotaviruses and Colorado tick
19
Q
non enveloped RNA viruses
A
reo (rota + colti)
calici (noro and sapo)
picorna (Hep A, rhino, Coxsackie A&B, polio, entero)
20
Q
calici: envelope?, genome, members
A
no envelope; ssRNA; noro and sapo
21
Q
reo: envelope? genome, members
A
no envelope, ds segmented RNA (THE ONLY)
rota (gastroenteritis in children <2) and Colorado tick fever
22
Q
rota - which family and what causes
A
reo family, ds segmented RNA, causes gastroenteritis in children <2
23
Q
picorna: envelope? genome, members
A
no envelope, ssRNA
Coxsackie A and B (B –> myocarditis); Hep A; rhino (common cold), polio
24
Q
Which is a paramyxovirus which causes many respiratory infx in epidemics each winter. Common cause of bronchiolitis in infants, complicated by pneumonia in 10% of cases?
influenza
rubella
coxsackie
respiratory syncytial virus
A
RSV (ssRNA)
flu is orthomyxo (ssRNA)
coxsackie is picorna (ssRNA)
rubella is toga (ssRNA)
paramyxoviridae: ENVELOPED! have spikes
except RSV, have HA and NA (or fusion protein) in these spikes
25
paramyxoviridae: genome, envelope? members
ssRNA, envelope (spikes, NA, HA, fusion protein)
RSV, measles, mumps, paraflu
26
Cytopathic effect (CPE) is a single mechanism of infx.
All viruses cause CPE.
both true
both false
1 true, 2 false
1 false, 2 true
both false
not all cause CPE
CPEs:
necrosis, hypertrophy, giant cell formation, hypoplasia, metaplasia, altered shape, detachment from substrate, lysis, membrane fusion, inclusions, apoptosis
27
All of the following are Herpesviridae except
VZV
EBV
CMV
coxsackie (A&B)
coxsackies
are picorna (non enveloped, ssRNA)
herpesviridae are dsDNA, enveloped, replicate in nucleus
bud from Golgi!
all can establish silent infxs
28
DNA enveloped viruses
herpes, pox, hepadna
29
HSV1 latency site
trigeminal ganglion
30
HSV2 latency site
sacral ganglia
31
VZV latency site
DRG and cranial nerve ganglia
32
CMV latency site
endothelium and T lymphocytes
33
EBV latency site
memory B
34
vesicular rash
HSV1, HSV2, VZV
35
oncogenic herpesviridae
EBV and Kaposi (herpes 8)
36
Prions are most recently recognized and simplest infx agents, consisting of a single protein molecule
Prions contain no nucleic acid and therefore no genetic info
both true
both false
1 true, 2 false
1 false, 2 true
both true
| Creutzfeldt-Jakob, mad cow
37
HSV2 is mainly spread through sexual contact
It cannot be spread from mother to infant during childbirth
both true
both false
1 true 2 false
1 false 2 true
1 true 2 false
of all herpesviridae, 1 and 2 recur in otherwise healthy ppl
38
Which of the following herpes lesions can be tx prophylactically by a vaccine?
```
HSV1
HSV2
VZV
EBV
CMV
```
VZV
two distinct phases: varicella (chicken pox) and zoster (shingles)
live attenuated vaccine done
39
Bacteriophage with ability to form stable, nondisruptive relationship within a bacterium is called a:
virulent phage
plasmid
temperate phage
phage T4
temperate phage
T4 infects E cole
plasmids: extrachoromosomal ds circular DNA with independent replication
40
bacterial virus
bacteriophage
41
cell within which virus replicates
host cell
42
integration into host genome without killing host
lysogenic cycle?
43
viral multiplication within host cell leading to destruction
lytic cycle
44
transfer of DNA from donor to recipient with DNA packaged in bacteriophage
transduction
45
transduction
transfer via bacteriophage
46
transformation
uptake of naked DNA
47
conjugation
exchange via F pili
48
Retroviruses contain RNA genome and reverse transcriptase.
Provirus forms as viral RNA; directly incorporated in host DNA.
both true
both false
1 true 2 false
1 false 2 true
1 true 2 false
provirus is DNA
for RNA viruses: transcription in c/pl except retroviruses and influenza
RNAdRNApol for all except retro (reverse transcriptase)
for DNA viruses: transcription in nucleus except pox
uses host DNAdRNApol
49
transcription of RNA viruses
in c/pl except flu and retro
| viral RNAdRNApol except reverse transcriptase
50
transcription of DNA viruses
nucleus except pox
| host DNAdRNApol
51
```
All these are enveloped RNA except
rubella
flu A, B, C
rota
measles
```
rota is not enveloped
52
do adenoviridae have envelope?
no
53
does papilloma have envelope? what's the genome?
no envelope, DNA
54
HepC: family, genome, envelope?
flaviviridae, ssRNA, no
55
retroviridae: envelope?
yes
56
Human adenoviruses are unlikely to target CNS BECAUSE adenoviruses prefer epithelial cells for replication.
```
both correct and related
both correct but unrelated
statement correct, reason wrong
statement not correct, reason correct
both wrong
```
both correct and relatedadeno - naked dsDNA
cause pneumonia, bronchitis, conjunctivitis
57
FOUR items assoc with polio
```
reo
salk vaccine
polio
sabin vaccine
transverse myelitis
picorna
MME vaccine
```
salk (IV deactivated)
polio (destroys ventral horns, mm paralysis)
sabin (oral live attenuated)
picorna (no envelope, ssRNA)
other picorna - HepA, rhino, entero, coxsackies
58
largest and most complex DNA:
pox
herpes
papova
parvo
pox
smallpox
enveloped, complex non-icosahedral shape
replicates in c/pl (unlike other DNA)
requires own DNAdRNApol because of that
other DNAs: hepadna (enveloped), papova (naked), adeno (naked), herpes (enveloped)
59
sabin vs salk and for what
polio
sabin oral live attenuated
salk IV deactivated
60
segmented RNA
reo
61
All are picorna except
```
polio
coxsackie
entero
hepadna
hep A
rhino
```
hepadna
picorna is ssRNA (naked)
hepadna is dsDNA enveloped
coxsackie A - herpangina, foot and mouth
62
EBV causes all except
```
Kaposi
infx mono
nasopharyngeal carcinoma
Burkitt's
oral hairy leukoplakia
```
Kaposi (which is herpes 8)
63
HIV1 and HIV2 are lentiviruses BECAUSE of their slowly progressive clinical effects
```
both true and related
both true but unrelated
first true second wrong
1 wrong 2 true
both wrong
```
correct and related
enveloped with spikes
genes: enc (for envelope proteins gp120 (binding) and gp41), pol (enzymes: reverse transcriptase, protease and integrase) and gag (core proteins)
CD4
giant cell CPE
64
lentiviruses
HIVs
65
retroviruses
lenti (HIV) and onco (HTLV)
66
HIV enzymes
env (gp120 and 41)
pol (enzymes: reverse transcriptase, protease and integrase)
gag (core proteins)
67
All negative polarity except
orthomyxo
paramyxo
rhabdo
retro
retro - + polarity
+ polarity can transcribe from original RNA
- polarity need RNAdRNApol
68
Child; recent vaccination (vaccinia).
Malaise and fever in hx, now rash on trunk and face.
variola
VZV
CMV
HSV1
VZV
vaccinia is against chicken pox
69
Flu has all except
```
ssDNA
hemagglutinin
neuraminidase
genetic reassortment
lipoprotein coat
```
ssDNA
wrong, has ssRNA
orthomyxo
enveloped
hemagglutinin - attachemtn
neuraminidase - penetration
antigenic shifts: reassortment
antigenic drifts: point mutations
70
Reye's
encephalopathy, contraindicated in children, aspirin
also flu!
71
swelling of parotids
mumps
paramyxo, ssRNA, enveloped
orchitis and deafness as complications
72
skin rash w. Koplik spots
measles = rubeola
paramyxo
73
flu-like sx and lymphadenopathy + rash on whole body
rubella (toga, enveloped ssRNA)
74
complications include Reye's syndrome
influenza!
orthomyxo, enveloped ssRNA
amantadine, rimantadine
75
Order steps in replicative cycle of virus.
A. release by budding through host plasma membrane or plasma membrane rupture
B. Replication and viral protein production
C. Attachment through receptor
D. Assembly of new virus particles
E. Entry via receptor-mediated endocytosis or membrane fusion
F. Uncoating triggered by pH changes in endosomes
C E F B D A
```
growth phases:
adsorption
eclipse (uncoating, can't detect)
synthetic (around 12 hours post-infx, assembly of particles)
latent - no extracellular
```
76
Orthomyxo and Paramyxo share all except:
```
spherical shape
ssRNA
segmented RNA
hemagglutinin
-ssRNA
```
segmented
both enveloped, -ssRNA
paramyxo form syncytia
77
All cross placenta except:
```
rubella
herpes
HIV
measles
CMV
```
measles
reoviruses are the ONLY RNA that are double stranded
78
Which family includes rubi (rubella) and alpha (arthropod-borne)
```
picorna
reo
flavi
calici
toga
```
toga
rubella: flu-like, lymphadenopathy, then rash
congenital rubella - deafness, cataracts, heart defects
mumps - orchitis and deafness
Koplick = корь = rubeola aka measles
79
All are characteristics of Staph aureus except:
```
coagulase-negative
Gram +
causes infective endocarditis
possesses surface protein A
causes Toxic Shock Syndrome
```
coagulase-negative
Staph aureus is coagulase positive! other staphs are coagulase negative
80
THREE items associated with Staph aureus
```
protein A
streptokinase
causes toxic shock syndrome
M protein
streptolysin O
causes scalded skin syndrome
gas gangrene
```
protein A
toxic shock
scalded skin
81
M protein
Strep pyogenes
82
streptolysin
Strep pyogenes
83
exfoliative toxins
Staph aureus, scalded skin
84
botulinum neurotoxin
clostridium botulinum, botulism, mm and nn paralysis
85
gas gangrene
clostridium perfringens exotoxin
86
Predominant skin bacteria:
lactobacilli
lactic acid bacteria
Neisseria
staph
staph
other is corynebacteria
87
predominant oral cavity bacteria
streps, lactobacilli
88
predominant colon bacteria
bacteroides, lactics, enterics, clostridia
89
Lancefiled groupings are based on antigenic characteristics of cell wall carbohydrate called A substance.
Main pathogenic groups for humans are A, B, C, D, and G.
both true
both false
1 true 2 false
1 false 2 true
1 false, 2 true
Streps: catalase negative (unlike staphs!)
facultative anaerobes
Lancefield is classification of Streps based on C substance in cell wall (A-G pathogenic for human)
hemolysis patterns: complete beta, incomplete alpha, no gamma
90
beta hemolysis
complete
91
alpha hemolysis
incomplete (viridans?)
92
catalase in streps and staphs
streps -, staphs +
93
coagulase in staphs
all - except aureus
94
phases of bacterial growth
A - lag (active but not dividing)
B - log (growing and dividing exponentially, fastest most constant growth)
C - maximum stationary, some nutrients become depleted, toxic wastes accumulate
D - death - logarithmic decrease
95
Endotoxins are part of outer membrane of cell wall of
G+ only
G- only
both G+ and G-
neither; only in viruses
G-
endotoxin is LPS!
very pyrogenic, very potent, non-specific
96
Which is essential to the fx of outer membrane of G-?
protein
p-antigen receptors
coagulase
LPS
LPS
LPS = lipid A, core polysaccharide and O antigenic side chain
97
LPS composition
lipid A, core polysaccharide and O antigenic side chain
98
Detection of protein A can be used as specific id test for
strep pyrogenes
Neisseria gonorrhoeae
salmonella
staph aureus
staph aureus
99
Each produce hyaluronidase except:
staph aureus
strep pyogenes
bordetella pertussis
clostridium perfringens
bordetella pertussis
streps staphs and clostrs mak hyaluronidase and hymolysins
cholera and shigella make neuraminidase
100
which bacteria make neuraminidase
vibrio cholera and shigella dysenteriae (degrade intestinal mucosa)
101
Mycobacterium along with related Nocardia are classified as
coagulase +
collagenase +
acid-fast
phospholipase +
acid-fast
collagenase + is clostridium
coagulase + is only staph aureus
phospholipase + is clostridium perfringens
102
collagenase +
clostridium
103
phospholipase +
clostridium perfringens
104
In addition to peptidoglycan, acid fast cell wall of mycobacterium contains a large amt of glycolipids, especially _______ that make up ~60% of acid-fast cell wall
beta-lactamases
LPS
teichoic acids
mycolic acids
mycolic acids
tubercle of Ghon - primary lung lesion
105
teichoic acids
in G+ walls
106
Major factor of cariogenicity of S mutans is ability to adhere to tooth surface. Attachment achieved due to presence of extracellular glycocalyx, or:
plasma membrane
capsule
pellicle
reticulum
capsule
protects against phagocytosis, mediates adherence
107
Associated with G- cell wall:
```
thick murein layer
LPS
teichoic acids
mycolic acids
thin murein layer
```
LPS, thin murein
murein is cell wall PG
N-acetylmuramic acid
108
component of bacterial PGs
N-acetylmuramic acid
109
most species of lactic acid bacteria ferment glucose to galactose
lactobacillus specs frequently found in association with dental caries
both true
both false
1 true 2 false
1 false 2 true
1 false 2 true
ferment glucose into lactate (hence name)
strep is culprit in dental caries
actinomyces - root surface caries
110
Localized aggressive periodontitis bacteria are capnocytophaga ochraceus and
actinobacillus actinomycetemcomitans
wolinella recta
porphyromonas gingivalis
actinomyces israelii
Actinobacillus actinomycetemcomitans (Aa)
Generalized aggressive: Prevotella intermedia and Eikinella corrodens
--> rapid severe periodontal destruction around most teeth
15-25 yo
Localized aggressive: Capnocytophaga + Aa
12-19 yo
rapid and sever attachment loss at incisors and first molars + relative absence of plaque
also assoc w periodontitis in juvenile diabetes
111
Generalized aggressive periodontitis
15-25 yo
rapid sever generalized attachment loss
Prevotella intermedia and Eikenella corrodens
112
Localized aggressive periodontitis
12-19 yo
first molars and incisors, no plaque (n/ph dysfx?)
Capnocytophaga and Aa
113
Strep mutans grows optimally at pH < 7. It is
```
acidophilic
acidogenic
aciduric
alkaliphilic
neutrophilic
```
acidophilic
lactic acid is main enamel decalcifier
114
E coli is in family Enterobacteriaceae. All characteristic except:
```
capnophilic
facultative anaerobes
G-
rod shaped
flagellated
```
capnophilic
other well known enterics and Salmonella (typh) and Shigella (dysent)
115
Which is not characteristic of Strep pyogenes:
group A
G-
nonmotile
catalase -
G-
this is false, it's G+
most streps are facultative anaerobes
116
alpha hemolytic streps
strep pneumoniae, strep viridans (endocarditis + caries)
117
Order phases of phagocytosis:
A. Fusion of phagosome with lysosome to form phagolysosome
B. Formation of residual body containing indigestible material
C. Formation of phagosome
D. Chemotaxis and adherence of microbe to phagocyte
E. Discharge of waste material
F. Ingestion of microbe by phagocyte
G. Digestion of ingested microbe by enzymes
D F C A G B E
118
Which is transferring DNA by cell-cell contact?
conjugation
ability to conjugate depends on presence of F+, coded by plasmid
119
Transcription occurs in:
c/pl of prokaryotes and nucleus of eukaryots
c/pl of eukaryotes and nucleus of prokaryotes
nucleus of both
c/pl of both
c/pl in prokaryotes, nucleus in eukaryotes
| transcription - from DNA to short-lived mRNA
120
Attachment of microbes and other foreign cells to phagocytes by antibody molecules such as IgG and complement proteins such as C3b is called
conjugation
transformation
opsonization
adhesion
opsonization
two major opsonins are IgG and C3b
121
M protein of Strep
resistance to phagocytosis
122
DNAses A to D
cleaves DNA
123
Streptococcal pyrogenic exotoxins
many manifestations
124
Streptolysin O and S
lysis of blood cells
125
Streptokinase A and B
dissolves fibrin
126
hyaluronidase
breaks down hyaluronic acid
127
strep exotoxin A
toxic shock
128
strep exotoxin B
rapidly destroys tissue
129
Spirochetes are a principal etiologic factor in necrotizing ulcerative gingivitis.
Prevotella intermedia is the most common spirochete found in pts with this dz.
both true
both false
1 true 2 false
1 false 2 true
1 true, 2 false
ANUG: Prevotella intermedia and spirochetes (like Treponema denticola)
Prevotella is not a spirochete
130
Prevotella intermedia dzz
Generalized aggressive periodontitis and ANUG
131
All are eukaryotes except:
fungi
plants
protozoa
bacteria
bacteria
132
Aerobic respiration is more efficient than fermentation BECAUSE aerobic respiration utlizies metabolically derived organic acids as terminal electron acceptors.
```
both correct and related
both correct but not related
1 true 2 false
1 false 2 true
both false
```
1 true 2 false
133
Bacteria most strongly linked with localized aggressive periodontitis is
porphyromonas gingivalis
tannerella forsythia
Aa
prevotella intermedia
Aa
134
Anaerobic bacteria produce superoxide dismutase and catalase.
Most bacteria grow in either presence or absence of oxygen.
both true
both false
1 true 2 false
1 false 2 true
1 false 2 true
superoxide dismutase and catalase in obligate aerobes
135
Some G+ but never G- (like Bacillus and Clostridium) are spore formers.
Spore contains complete cope of chromosome, bare minimum of essential proteins and ribosomes and high amts of Ca bound to dipicolinic.
both true
both false
1 true 2 false
1 false 2 true
both true
136
One of the most common forms of traveler's diarrhea is caused by an enterotoxin produced by
bacteroides
E coli
Neisseria
eikenella
e coli
| s aureus and vibrio cholera also produce enterotoxin
137
DNA is generally confined to
nucleoid
138
site of translation
ribosomes
139
storage of reserves of nutrients
inclusions
140
attachment to surfaces
capsulealso protective against phagocytosis
141
permeability barrier
plasma membrane
142
motility
flagella
143
which of the following opportunistically infects the host and utilizes exotoxin A?
Neisseria gonorrhoeae
helicobacter pylori
pseudomonas aerugonisa
staph aureus
Pseudomonas aeruginosa
G-, aerobic, has cytochrome oxidase (Fe cofactor)
144
Which of the following is a symbiotic relationship in which both members benefit?
parasitism
mutualism
commensalism
margination
mutualism
145
A missense mutation is a genetic mutation in which nucleotides are either inserted or deletd from a DNA sequene.
Translation of mRNA derived from this mutated gene results in a protein with the incorrect AA sequence
both true
both false
1 true 2 false
1 false 2 true
1 false 2 true
146
Shrinkage in cell size by loss of cellular substance is known as
atrophy
hypertrophy
hyperplasia
metaplasia
atrophy
147
Tissue transferred between genetically different members of same species is known as
autologous graft
allogeneic graft
syngeneic graft
xenogeneic graft
allogeneic graft
autologous - from self
syngeneic - genetically identical individuals
allogeneic - same species
CD4 and CD8 most of destruction in graft rejection
most common hyperacute rejection is ABO mismatch
148
```
cellular degradation by enzymes derived from sources extrinsic to the cell is known as:
necrosis
heterolysis
autolysis
apoptosis
```
heterolysis
149
Interferons are species-specific proteins.
In contrast to antibodies, interferons are virus specific but not host specific.
both true
both false
1 true 2 false
1 false 2 true
first true, second false
IFNs are non-specific for viruses but specific for host
150
Small polypeptides released by a cell in order to change the fx of same or another cell are called
collectins
cytokines
defensins
effector cells
cytokines
151
Which metabolic pathway is used to convert arachidonic acid into PGs, prostacyclin or TXAs?
lipoxygenase
pentose phosphate
HMG-CoA reductase
COX
COS
lipoxygenase - related but LTS (bronchocontrictors)
pentose phosphate - regeneration of NADH
HMG-CoA - cholesterol synthesis
phospholipase A2 splits arachidonic acid from phospholipid
152
Serotonin (5 HT) is a preformed vasoactive mediator with actions similar to
heparin
thrombin
ACh
histamine
histamine
synthesized from tryptophan
153
Histamine is released largely by
```
m/ph
enteroendocrine cells
lymphocytes
n/ph
mast cells
```
mast cells
two major vasoactive amines are histamine and serotonin
anaphylaxis, dilation of arterioles, increased permeability of venules
154
All about plasmin are correct except:
also called fibrinolysin
proteolytic enzyme derived from plasminogen
essential in blood clot dissolution (fibrinolysis)
component of non-specific immune system
most important fibrinolytic protease
immune
155
Autoimmune dz impairs fx of cells in kidney that produce renin. Which product of adrenal cortex is affected?
```
Angiotensinogen
angiotensin I
angiotensin II
angiotensin converting enzyme
aldosterone
```
aldosterone
angiotensinogen is constantly circulating
converting enzymes - in lungs
156
Cytochromes are found in m/ch inner membrane of prokaryotes.
M.ch electron transport proteins are clustered into complexes I, II, III and IV
both true
both false
1 true 2 false
1 false 2 true
1 false 2 true
I - FMN
II - CFAD
III - CoQ cytochrome c
IV - cytochrome c oxidase (components are cytochromes a)
cytochrome oxidase is terminal enzyme
157
Which interleukin favors TH-1 type responses and counteracts IL-10?
IL-1
IL-2
IL-6
Il-12
IL-12
158
m/ph IL
IL-1, promotes inflammation
159
IL that stimulates proliferation and activation of T and B
IL-2
160
IL that promotes B activation and IgE antibodies
IL-4
161
IL that causes B cells to produce IgA
IL-5
| stimulates eosinophils
162
IL that produces fever
IL-6
163
IL that inhibits TNF and IL-12 and suppresses inflammatory rxns and TH-1
IL-10
164
stimulates hematopoiesis
IL-3
165
can induce apoptosis
TNF alpha
166
simulates IL-2 secretion, induces fever
IL-1
167
stimulates T-killers
IL-2
168
stimulates chemotaxis and adhesions of neutrophils
IL-8 sticky
169
bacterial cell wall component susceptible to lysozyme is
LPS
teichoic acid
lipoprotein
peptidoglycan
peptidoglycan
170
Which is site of mRNA attachment and AA assembly?
```
nucleolus
lysosomes
plasma membrane
Golgi
ribosomes
```
ribosomes
171
catalase and other enzymes that break down hydrogen peroxide are located in
lysosomes
inclusion bodies
microbodies
centrioles
microbodies (eg peroxisomes)
```
superoxide dismutase
catalase
glutathione peroxidase
ceruloplasmin
transferrin
```
172
All are potential characteristics of T cells except
```
CD3+
CD4+
CD8+
antigen recognition requires MHC proteins
frontline phagocytic cells
```
frontline phagocytic cells
this is wrong
CD3 is for T-cell receptor recognition of MHC
173
Surface membrane Ig is a marker for
mature T
n/ph
mature B
monocytes
mature B
IL-2 potentiates natural killers
CD8+ release perforins and induce apoptosist cells - cell-mediated immunity
174
Surgical wound closed by sterile suture would heal by
first intention
second intention
third intention
keloid formation
first intention
inflammation without infx
second closes without suture, too large, edges don't approximate, via granulation and filling with connective tissue
1 vs 2 determined by type of wound
third - with scar
175
Susceptibility to teratogens is specific for each developmental stage BECAUSE teratogens are dose dependent
both true but unrelated
maternal infx: TORCH
toxo other rubella CMV HSV
critical phase is first trimester
176
Sxx of sepsis include all except
```
fever
weakness
painful urination
nausea
vomiting
```
painful urination
cytokines of sepsis: TNF and IL-1
177
Which organ has a remarkable capacity to regenerate?
heart
brain
lungs
liver
liver
178
M/ph is dominant cellular player in chronic inflammation.
Mononuclear phagocyte system (reticuloendothelial system) concists of closely related cells of bone marrow origin, including blood monocytes and tissue macrophages.
both true
179
Order sequence of healing.
a. Epithelial bridges cross the wound.
B. Inflammation subsides and blanching begins.
C. Clotted blood covers incision and n/ph accumulate at wound margins
D. Connective tissue bridges the wound
E. Inflammatory cells are entirely absent
F. Granulation tissue fills the incision space
C A F D B E
inflammation absent after 1 month
180
Each causes dermatophytosis except:
blastomyces
microsporum
trichophyton
epidermophyton
blastomyces
most effective anti-fungal is griseofulvin
181
All are possible characteristic of fungi except:
dimorphic
prokaryotic
septated
sporulate
prokaryotic
182
Fungus that produces sexual spores is
anamorph
promorph
metamorph
teleomorph
teleomorph
183
Fungus with asexual spores
anamorph
184
Endemic mycoses are fungal infx caused by dimorphic fungal pathogens Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioides immitis, Coccidioides posadasoo, and Paracocccodioides brasiliensis.
All of these agents produce primary infx in heart, with subsequent dissemination to other organs and tissues
1 true 2 false
Coccidio is respiratory
Blastomycosis too
Histoplasmosis can cause tuberculosis-like infx
Meds: amphotericin B, fluconazole
185
Which is opportunistic in diabetes, leukemia, sever burns or malnutrition?
aspergillosis
cryptococcosis
zygomycosis
dermatophytoses
zygomycosis
186
cryptococcus
meningitis, esp HIV
| pigeons
187
aspergilllus
lungs, birds
188
All are superficial mycoses except
```
malassezia furfur
aspergillus fumigatus
hortae werneckii
piedraia hortae
trichosporon spp
```
aspergillus is lungs
189
Malaria in humans is caused by one of four protozoan species of the genus:
trichomonas
plasmodium
cryptosporidium
toxoplasma
plasmodium
most serious is falciparum
others are vivax, malariae and ovale
190
toxoplasma
cat feces, crosses placenta, encephalitis in AIDS
191
etiologix agent of amebic dysentery?
giardia lamblia
trichomonas vaginalis
balantidium coli
entamoeba histolytica
entamoeba histolytica
trophozoite - active phase, cyst - dormant
tx w metronidazole
giardia also exists in two forms
trichomonas exists only as trophozoite, STD
balantidium is largest protozoan parasite
192
Which is acquired by ingesting undercooked meat containing tissue cysts or food contaminated by cat feces
cryptosporidiosis
trichomoniasis
toxoplasmosis
giardiasis
toxoplasmosis
193
Helminths are the largest internal human parasite
helminths reproduce sexually, generating millions of eggs and larvae
both true
nematodes - round worms
trematodes - flukes
cestodes - tape worms
nematodes: hookworms, ascaris
trematodes: blood flukes (schistosome), lung flukes, intestinal/hepatic flukes
cestodes: ribbon-shaped, intestinal adult worms (no intestinal tract in these worms): taenia, diphyllobothrium
marked eosinophilia
194
cestodes are
tapeworms
195
nematodes are
roundworms (ascaris, hookworms)
196
trematodes are
blood flukes (schistosome)
197
THREE items associated with adult polycystic kidney disease:
```
autosomal dominant
shrunken kidneys
corticomedullary cysts
large multicystic kidneys
liver cysts
hepatic fibrosis
```
AD
corticomedullary cysts
large multicystic kidneys
most common inherited nephropathy
for comparison, childhood PKD is recessive + hepatic fibrosis
198
Malignant HTN can adversely affect all major organ systems. The most susceptible is
```
intestines
lungs
heart
brain
kidneys
```
kidneys
chronic HTN leads to arteriosclerosis
199
Nephrolithiasis is manifested by severe spasms of pain (renal colic) and hematuria, often with recurrent stone formation.
Most commonly occurring form is strutive.
1 true, 2 wrong.
80-90% of kidney stones are Ca.
200
Causes of hydronephrosis include all except:
```
nephrolithiasis
blood clot
tumor in or around ureter
bacterial infx
pregnancy
```
bacterial infx
--> causes pyelonephritis
urolithiasis is Ca or oxalate or both
in gout, hyperPTH, hyperCa emia
201
nephrotic syndrome (glomerular dz) - all except
```
heavy proteinuria
lipiduria
hyperalbuminemia
hyperlipidemia
severe edema
```
hyperalbuminemia
albumin is lost! everything is lost, increased permeability
202
nephritic vs nephrotic
nephritic is inflammation, ischemia, HTN, hematuria
nephrotic is proteinuria and edema
203
Which is classic presentation of acute poststreptococcal glomerulonephritis?
rapidly progressing glomerulonephritis
nephroti syndrome
nephritic syndrome
nephrolithiasis
nephritic syndrome
nephritic syndrome is due to glomerular dz; CLASSIC presentation of acute poststreptococcal glomerulonephritis
204
Dominant intrahepatic cause of portal hypertension is
obstructive thrombosis
sever right-sided heart failure
cirrhosis
constrictive pericarditis
cirrhosis
prehepatic: obstructive thrombosis, massive splenomegaly
posthepatic: tight heart failure, pericarditis, outflow obstruction (Budd-Chiari)
four major clinical consequences are: ascites; portosystemic shunts; congestive splenomegaly; hepatic encephalopathy, upper GI bleeds
205
posthepatic portal HTN causes:
hepatic vein obstruction, right side failure, pericarditis
206
sequelae of portal HTN
ascites, splenomegaly, hepatic encephalopathy, portosystemic shunts,
upper GI bleeds
207
prehepatic portal HTN causes
thrombosis, splenomegaly
208
Ascites is accumulation of excess fluid in pleural cavity.
In 85% cases, ascites is caused by cirrhosis.
1 false, 2 true
peritoneal accumulation
209
Aside from xanthomas and pruritis, other manifestation of cholestasis is:
proteinuria
hypoBbemia
albuminemia
jaundice
jaundice
210
Most common symptom of hepatocellular carcinoma is:
```
abdominal pain
confusion
wt loss
impotence
nausea
```
abdominal pain
Hep C - 80% cases with cirrhosis
Hep B - without cirrhosis
viral incubation generally 2-8 wks
211
THREE items associated with hepatitis B
```
fecal-oral transmission
IV drug abuse
anti-HAV IgM
anti-delta agent antibody
perenteral transmission
HBsAg
```
IV, parenteral, HBsAg
HBsAg - first positive marker of acute infx
most pts recover fully
no association of HepA with HCC (yes for B and C)
212
All are characteristics or sequelae of cirrhosis except:
```
fibrous septae
more prevalent in females
parenchymal regeneration
portal HTN
hepatocellular carcinoma
```
more prevalent in females
this is false; twice as common in men
cirrhosis: nodules + fibrosis
most common cause - alcohol abuse
213
which type of emphysema is associated with aging and alpha1-antitrypsin deficiency?
paraseptal (distal acinar)
centriacinar (centrilobular)
panacinar (panlobular)
irregular
panacinar (panlobular)
emphysema = irreversible enlargement of airspaces DISTAL to terminal bronchiole + destruction of walls WITHOUT fibrosis.
lack of elastic recoil, increase in compliance
types:
centriacinar: chronic bronchitis and smoking; most common; upper lobes, respiratory bronchioles
panacinar: aging and alpha1-antitrypsin deficiency; lower loves, alveoli and acinar ducts
paraseptal (distal): spontaneous pneumothorax in young adults
emphysema + chronic bronchitis = COPD
214
centriacinar emphysema
most common; respiratory bronchioles; upper lobes; smoking and bronchitis
215
panacinar emphysema
alpha1-antitrypsin deficiency and aging; lower lobes; alveoli and alveolar ducts
216
COPD = which two?
emphysema + chronic bronchitis
217
smooth mm hyperplasia, excess mucus, inflammation in lungs
asthma
218
mucous gland hyperplasia, hypersecretion
chronic bronchitis
at least 3 months in at least 2 consecutive yrs
219
airspace enlargement, wall destruction
emphysema
220
airway dilation and scarring
bronchiectasis
221
inflammatory scarring/obliteration
bronchiolitis
222
Most common type of asthma, atopic asthma, is a classis example of:
type I IgE-mediated hypersensitivity
type II IgE-mediated hypersensitivity
type III IgE-mediated hypersensitivity
type IV IgE-mediated hypersensitivity
type I
atopic - with evidence of sensitization
bronchospasm, mucus hypersecretion, inflammation in lungs, smooth mm hyperplasia
223
chronic bronchitis
mucus hypersecretion and hyperplasia
224
Causes of left-sided congestive heart failure include all except:
pulmonary edema
ischemic heart dz
mitral regurgitation
myocarditis
pulmonary edema
225
malabsorption of fat soluble citamins is likely in most patients with:
Von Hippel-Lindau
cystic fibrosis
marfan's syndrome
familial hypercholesterolemia
cystic fibrosis
bc impaired exocrine fxs
sweat test - diagnostic (reabsorption impaired)
226
Marfan typical
tall, thin, long legs and arms; connective tissue disorder
227
What's caused by inhalation of carbon dust:
asbestosis
silicosis
coal worker's pneumonia
anthracosis
anthracosis
pneumoconiosis: inhalation of inorganic dust particles; lead to fibrosis of lungs
anthracosis: carbon dust
coal workers - coal dust (C + Si); can be simple and progressive massive
silicosis - free Si dust; most common, most serious, assoc with TB
asbestosis --> diffuse interstitial fibrosis; bronchiogenic carcinoma and malignant mesothelioma of pleura
228
asbestosis
most malignant, diffuse interstitial fibrosis
229
silicosis
associated with TB, most serious and common
230
coal workers
Si + C; simple and progressive massive
231
anthracosis
C
232
Interstitial pneumonia is most often caused by Strep pneumoniae.
Virulence of pneumococcus is associated with its capsular polysacch.
first false, second true
types of pneumonia:
lobar (Strep, intra-alveolar, middle age)
bronchopneumonia (wide variety of m/o, patchy, bronchioles and alveoli, elderly and infants)
interstitial (Mycoplasma or viruses; diffuse and patchy in walls, young children)
233
most common cause of pneumonia in young children
viruses
234
virulence of streps - main component
polysaccharide capsule
235
which is most often responsible for ling abscesses
proteus
klebsiella
staphs
pseudomonas
staph
236
TWO items associated with nodular melanoma
```
most common type of melanoma
radial growth phase predominates
vertical growth phase predominates
Hutchinson freckle
least common type of melanoma
bleeding or ulceration
```
vertical growth predominates
bleeding or ulceration
melanoma is most deadly skin cancer
related to sun exposure (sunburns during childhood)
melanocytes
growth phases:
radial (initial): horizontal spread in epidermis and supf dermis; prominent lymphocyte response, no metastatic
vertical: invade deeper layers; nodule appears; metastatic potential
clinical variants: most common is supf spreading (large flar, pigmented, mostly radial)
nodular is most aggressive, poorest prognosis, mostly vertical
lentigo - radial growth, Hutchinson freckle
acral-lentiginous - least common, on palm or sole; maybe not sun-related
237
most aggressive melanoma
nodular, vertical
238
most common melanoma
superficial, radial
239
Hutchinson freckle
lentigo melanoma
240
All are symptoms of pheochromocytoma except:
```
bradycardia
HTN
headaches
palpitations
diaphoresis
```
bradycardia
pheochromocytomas - chromaffin cells; catecholamines
241
Most aggressive lung tumors, metastasize widely and are virtually incurable by surgical means:
epidermoid (squamous cell)
adenocarcinoma
small cell (oat cell)
large cell (anaplastic)
small cell (oat cell)
epidermoid (squamous cell): near hilus, related to smoking and men
adenocarcinoma:
periphery of lung, women, most common
small cell - most aggressive and highly malignant, near hilus; related to smoking
large cell(anaplastic) - variable, least common
242
lung cancers related to smoking
squamous cell and small cell, both near hilum
squamous is male
small cell is v malignant and aggressive
243
Which of these lymphomas usually involves abdominal organs and is closely linked to EBV?
```
non-Hodgkin
Hodgkin
mantle cell
burkitt's
follicular
```
burkitt's
extra-nodal presentation is common in non-Hodgkin
244
Hodgkin vs non-Hodgkin
presence of Reed-Sternberg in Hodgkin
245
All of the following are peripheral T-cell and NK-cell neoplasms except:
mycosis fungoides/sezary syndrome
large granular lymphocytic leukemia
anaplastic large-cell lymphoma
Burkitt's
Burkitt's
is aggressive B
246
Invasion of dermis by sheets and islands of neoplastic epidermal cells, often with keratin pearls, is characteristic of:
```
squamous cel carcinoma
basal cell carcinoma
malignant melanoma
nodular melanoma
lentigo maligna melanoma
```
squamous cell
more aggressive than basal; sun exposure
often keratotic, may ulcerate
90% of malignant cancers of oral cavity
247
most cancers in oral cavity are
squamous cell carcinomas
248
Basal cell carcinomas frequently metastasize BECAUSE they are locally aggressive and can form ulceration and bleed
first wrong, second true
basal cancers are invasive but not very metastatic
characterized by palisading
249
most invasive cancer
basal cell
250
most severe skin tumor
malignant melanoma
251
Which is most likely to produce free radicals:
alkylating agent
UV light
virus
ionizing radiation
ionizing radiation
UV - cross-linking of bases in DNA
ionizing -- free radicals
cells with high proliferation more sensitive to radiation
252
_____ of the coon is most common malignancy of GI tract and is a major cause of morbidity and mortality worldwide.
sarcoma
adenocarcinoma
lymphoma
adeno
small intestine is uncommon for tumors
colorectal adenocarcinoma is second only to lung cancer
sigmoid most common
253
Pt has prostate cancer. In addition to increase in prostate-specific antigen (PSA), which serum marker might also be elevated?
human chorionic gonadotropin
acid phosphatase
carcinoembryonic antigen-125
bence jones protein
acid phosphatase
prostate - most common cancer in men
lung cancer - most common killer on both genders
254
Rhabdomyosarcoma is benign neoplasm from skeletal mm.
Leiomyomas, malignant smooth mm neoplasms, are most common neoplasm in women.
both false
sarcoma is malignant
leiomyoma is most common in women but benign
255
All are characteristic or associations of breast cancer except:
```
positive family hx
late menarche
diet high in animal fats
delayed first pregnancy
obesity
```
late menarche
breast cancer - most common cancer; number 2 killer in women after lung
more commonly in left, outer upper quadrant
lymphatic widespread metastasis
early menarche, late menopause!
late first pregnancy (after 30)
256
5yr survival rate of bronchogenic carcinoma is close to:
```
10%
20%
50%
60%
80%
```
10%
bronchogenic carcinoma - leading cayse of death from cancer
directly proportional to smoking
50% inoperable at time of diagnosis
257
Often first signs of lung cancer are related to metastatic spread, particularly to:
liver
heart
brain
thyroid
brain
metastasis through lymphatic channels
258
lung cancer gender prevalence
M:F = 4:1
259
Hallmark of ___ is resebce of clonal malignant Reed-Sternberg cell in a lymph node biopsy or (rarely) extranodal tissue
chornic lymphocytic leukemia
non-Hodgkin lymphoma
multiple myeloma
Hodgkin lymphoma
Hodgkin
predominantly young men
commonly assoc w EBV and HIV
260
Palpable mass lesions on digital rectal exams. What is most likely to indicate that neoplasm is malignant?
```
pleomorphism
atypia
metastasis
increased nuclear/cytoplasmic ratio
necrosis
```
metastasis
most important characteristic that distinguishes malignant from benign
261
THREE items associated with multiple myeloma:
```
"punched-out" bone lesions
hypoCaemia
peak age 25-30
bence jones protein
T-cell proliferation
B-cell proliferation
urticaria
```
"punched-out" bone lesions
bence jones protein
B-cell proliferation
multiple myeloma - multifocal in skeleton
chiefly in elderly, 65-70 yo
Bence-Jones - free Ig in urine
hyperCaemia bc escapes from bones
excessive growth and malfx of plasma cells in bone marrow
262
Which contains recognizable mature or immature cells or tissues representative of more than one germ cell layer and sometimes all three?
carcinoma
sarcoma
teratoma
APUDoma
teratoma
APUDoma - amine precursor uptake and decarboxylation - produces hormone-like substances
263
Which is histologic landmark of malignancy?
dysplasia
anaplasia
metaplasia
desmoplasia
anaplasia - absence of differentiation
histologic features of malignancy:
anaplasia, hyperchromatism, pleomorphism, abnormal mitosis
desmoplasia is forming fibrous stroma -- firm feel on palpation
264
All are benign mesenchymal tumors except:
osteogenic sarcoma
lipoma
fibroma
chondroma
osteogenic sarcoma
| is malignant
265
Ewing sarcoma family of tumors encompasses Ewing sarcoma and primitive neuroectodermal tumor (PNET), which are primary malignant small round-cell tumors of bone and soft tissue.
Ewing sarcoma and PNET together account for 6-10% of primary malignant bone tumors and follow osteosarcoma as second most common group of bone sarcomas in children.
both true?
266
malignant bone tumors
osteosarcoma and Ewing/PNET, in children
267
All are benign except:
```
adenoma
fibroma
carcinoma
hemangioma
lipoma
```
carcinoma
in general, benign tumors are well-differentiated
anaplasia (lack of differentiation) is characteristic of malignant tumors
268
Tumor from osteoclasts and osteoblasts
osteogenic sarcoma
269
On surface of bone instead of interior
parosteal osteogenic sarcoma
270
Malignant tumor from cartilage
Chondrosarcoma
271
Most commonly in long bones, especially knee
malignant giant cell tumor
272
Which bone tumor of nonosseous origin is characterized by constipation and visual disturbances?
Ewing
fibrosarcoma
chordoma
none
chordoma
Ewing - from bone marrow
chordoma - from notochord
273
Which is a cutaneous disorder marked by hyperkeratosis and pigmentation of axilla, neck, flexures and anogenital region?
```
dermatofibroma
seborrheic keratosis
acrochordon
acanthosis nigricans
actinic keratosis
```
acanthosis nigricans
most pts have cancer
dermatofibromas - benign nodules, accumulation of fibrobalsts
acrochordon - skin tag (neck, armpit, groin)
actinic keratosis - premalignant, sunlight
seborrheic keratosis - warts in older people
274
Melanoma in vertical growth that has invaded 1.5 mm into dermal layer has a higher metastatic potential than melanoma in horizontal growth phase.
Prognosis is best determined by measuring diameter of lesion.
first true, second false
prognosis determined by vertical growth
horizontal growth -- no metastatic potential
275
Schilling test may be used to detect:
folate deficiency
aplastic anemia
pernicious anmia
myelophthisic anemia
pernicious anemia
pernicious is B12 deficient megaloblastic anemia
Schilling tests for B12 absorption
stomatitis and atrophic glossitis are common
megaloblastic pernicious erythrocytes are macrocytic and hyperchromic
276
Arterial or cardiac thrombi usually begin at sites of turbulence or endothelial injury.
Venous thrombi tend to grow retrograde from point of attachment.
1 true, 2 false
Virchow's triad for thrombus formation: endothelial injury, stasis or turbulence, hypercoagulability.
All thrombi grow towards heart! Arterial retrograde, venous anterograde.
Venous mostly in legs. DVT can fly to lungs.
277
Body structures most vulnerable to high blood pressure include all of the following except:
```
blood vessels
small intestines
brain
kidneys
heart
```
small intestine
278
Most common cause of secondary HTN is:
pheochromocytoma
kidney dz
hypothyroidism
hyperparathyroidism
kidney dz
279
THREE items associated with normocytic classification of anemia
```
iron deficiency
thalassemias
aplastic anemia
anemia of chronic dz
liver dz
vitamin B12 and folate deficiency
acute and chronic blood loss
```
aplastic
chronic dz
acute and chronic blood loss
280
Macrocytic anemias:
liver dz
| B12 and folate deficiency (this is megaloblastic)
281
Normocytic anemias:
aplastic
chronic dz
acute and chronic blood loss
282
Microcytic:
iron deficiency
| thalassemias
283
Warfarin is an effective anticoagulant that fx by its antagonistic action on:
Vit A
Vit D
Vit E
Vit K
Vit K
284
Most common form of erythroblastosis fetalis is ABO incompatibility, which can vary in severity.
The less common form is called Rh incompatibility, which can cause very sever anemia in the baby.
both true
erythroblastosis fetalis is when mom and baby have different blood types. Mom's ABs attack baby's RBCs.
285
Classic pentad of thrombotic thrombocytopenic purpura includes all except:
```
microangiopathic hemolytic anemia
thrombocytopenia
liver dysfx
transient neurologic deficits
fever
renal failure
```
liver dysfx
Idiopathic is when low plt count
286
Which arteriosclerosis is characterized by calcific deposits in muscular arteries in persons older than 50?
Monckeberg medial sclerosis
atherosclerosis
hyperplastic arteriolosclerosis
hyaline arteriolosclerosis
monckeberg medial sclerosis
atherosclerosis is intimal lesions
287
In sickle cell anemia, globin portion is abnormal die to valine being substituted for which?
glutamine
glutamic acid
aspartic acid
glycine
glutamic acid
HbS
[in HbC, lysine replaces --> decreased plasticity of RBCs]
288
Flu-like symptoms but without fever. Cherry-red discoloration of skin, mucosa and tissues.
```
CO poisoning
mercury poisoning
fluoride poisoning
sarcoidosis
military TB
```
CO poisoning
affinity b/w CO and Hb is 200 stronger than with oxygen.
Hg --> renal
methanol --> blindness
289
Hemophilia A and von Willebrand dz both directly involve clotting factors.
Hemophilia B also directly affects clotting factor VIII.
first is true, second is false
A - 8 (classical), B - 9
all lab tests normal except: prolonged partial thromboplastin time
vWF is AD
