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Its not over, Until its over! > mosby 3 > Flashcards

mosby 3 Flashcards

1
Q

all of the following cells are associated with chronic inflammation except ?

a. macrophages
b. neutrophils
c. t lymphocytes
d. b lymphocytes
e. plasma cells/ig/b cells

A

neutrophils

-are quick to arrive to the site of infection of injury therefore asso. with acute inflammation

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2
Q

dust cells can be found in the ?

A

lungs
- along with heart failure cells are macrophages that are found in the lungs,they are part in reticulo endothelial system

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3
Q

which of the following mediators aid in the killing of intracellular bacteria?

a. histamine
b. interleukin 2
c. catalase
d. IgG
e. Lysozyme

A

lysozyme
-bacteria that ate phagocytosed by macrophages are keptin membrane boynd vacuoles called PHAGOSOME. phagosome will fuse with lysosome which contains many degradative enzymes uncluding LYSOZYME.

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4
Q

the class of antibodies that plays an important role of type 1 hypersensityvity.

a. IgA
b. IgD
c. IgE
d. IgG
e. IgM

A

IgE

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5
Q

most most common cause of subacute endocarditis?

A

Streptococcus Viridans

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6
Q

most common cause of acute endocarditis

A

staphilococcus aureus

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7
Q

di george syndrome is characterized by a deficiency of?

A

t lymphocytes

lack of t-cells and Pth

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8
Q

aschoff bodies are observed in which of the following conditions?

A

rheumatic fever

-a clasic lesion

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9
Q

endotoxin consist of ?

A

lipopolysacharrides

- gram negative

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10
Q

exotoxin cinsist of?

A

teichoic acid

-found in gram positive cell wall of bacteria

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11
Q

karyotyping can be used to diagnose which of the following diseases?

A

klinefelters syndrome

- extra bar bodies

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12
Q

in pemphygus,autoantibodies are directedagainst which of the following structures?

A

epidermis

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13
Q

epidermal cells appear to detach and separate from each other is called?

A

acantholysis

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14
Q 
which of the following is a majkr complication of chronic brinchitis?
myxedema
pneumothorax
emphysema
pernicious anemia
malignant transformation
A

malignant transformatiom
(bronchogenic carcinoma)

-due to smoking (bronchial epith to squamous epith)

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15
Q 
which of tthe following calls are defective in chronic granulomatous disease?
neutrophils
lymphocytes
plasma cells 
killer cells 
macrophages
A

neutrophils

  • granulomatous ds is a n innate immune deficiency primary affecting the phagocytic compartment
  • CGM results from neutrophils with defective NADPH oxidase system
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16
Q 
which of the following describes cells that are abnormal in appearance and may become premalignant?
aphasia
dysplasia
karyomegaly
pleomorphism
metaplasia
A

dysplasia
-abnormal in appearance and organization
the potential
-the potential to develop into malignant tumor is present

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17
Q 
the HIV virus binds directly to the surface receptors of CD4 lymphocytes with?
reverse transcriptase
integrase
hemagglutinin
glycoprotien 120
protease
A

glycoprotein 120

  • hiv envelope contains 2 glycoprotein,gp120 and gp41
  • gp120 binds specifically whith CD4 surface receptors
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18
Q 
which of the following microbes is the most common cause of gastroenteritis in children?
reovirus
picornaviruses
togavirus
paramyxoviruses
orthomyxoviruses
A

reovirus

- the most common cause of gastrownteritis in children is Rotavirus,found in reoviris family.

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19
Q

a cotton wool apprearance may be used to describe the radiograph of a patient with?

A

osteitis deformans/ paget’s ds

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20
Q

ehlers-danlos syndromeis a disease affecring

A

connective tissue

-defects in collagen

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21
Q 
autoclave sterilizes dental instruments by causing which of the following?
coagulation of proteins
denaturing of proteins
precipitation of nucleic acids
disruption of cell membranes
dissolution of lipids
A

denaturing proteins

-they are effective agains pores

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22
Q 
the most common cause of death in diabetic patients is?
peripheral neuropathy
pancreatic cancer
cardiovascular ds
kidney failure
opportunistic infections
A

cardiovascular ds
- the leading cause

others:

  • retinopathy
  • nepthropathy
  • peripheral neuropathy
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23
Q

neuramidase is produced by?

A

influenza virus ALONE!

-functions to attach the virus to host cell

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24
Q 
which of the following skin lesions is most likely premalignant?
verruca vulgaris
keloids
seborrhic keratosis
actinic keratosis
compound nevus
A

actinic keratosis
- produces dry,scaly plaques with erythematous base
as to nevi,only junctional nevi are considered to be premalignant.

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25
Q

the most lrominent mechanism of spread of heatitis A virus is by which of the ff.

A

oral-anal

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26
Q

accumulation of fluid in the pericardium accurs most offen with which of the ff conditions?

A

tamponade

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27
Q

the most common cause of pyelonephritis is?

A

e. coli

-pyelonephritis means inflammation on the kidney
commonly cause by e. coli ,kliebsiella and enterobacter

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28
Q

polycystic kidney ds is mosy commonly asso. with?

A

berry aneurysm

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29
Q

squamous cell carcinoma is the most common oral cancer. it is a tumor of?

A

keratinocytes

-a cancer of squamous epith. ,espc. tumor of kerstinocytes

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30
Q

tinea pedis,which is commonly known as athletes foot,is a fungal infection that is caused by the ff dermatophyte (s)?

A

trichophyton and epidermophyton

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31
Q

fibrotic and thickened heart valves that result is a reduction of blood flow through the valve characterize which of the ff.

A

stenosis (narrowing)

- caused by reduce blood flow through the valve

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32
Q 
cystic fibrosis is a hereditary dissorder that results from defective?
collagen
chloride channels
lysosomal enzymes
fibrillin
myelin
A

chloride channels -that affects all exocrine gland

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33
Q

the most common mutation accounting for pathogenesis of trisomy 21(down syndrome) is?

A

meiotic nonjunction

- in the mother,which results in an extra copy of chromosome 21 / trisomy 21

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34
Q 
an endocrine disorder that causes an early loss of primary teeth and the early eruption of secondary teeth?
myedema
hashimotos thyroiditis
digeorge syndrome
plummers ds
dwarfism
A

plummers ds

a. k.a. toxic nodulargoiter (hyperthyroidism px)
- caused by nodular growth or adenona of the thyroid/ goiter

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35
Q 
which of the ff is not a feature of poststreptococcal glomerulonepthritis?
hematuria
hypertension
edema
polyuria
A

polyuria (pag inflamed,less ang ihi)

-post streptococcal glomerulonepthritis an example of nepthritis syndrome after strep. infection (strept throat)

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36
Q

the most common cause of osteomyelitis is?

A

staphilococcus aureus and acute endocardistis

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37
Q 
all of the following arehistopathologicfeatures of malignant cells except one?
anaplasia
pleomorphism
aneuploidy
large nuclei
low nuclear-cytoplasmic ratio
A

low nuclear-cytoplasmic ratio

due to large nuclei present,there is usually high nuclear cytoplasmic ratio

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38
Q 
which of the ff best describes anaplastic cells that have not invaded the basement membrane and are confined within their epith of origin?
dysplasia
hyperplasia
metaplasia
sarcoma
carcinoma in situ
A

carcinoma in situ

- cells have not yet invadex the basement mwmbrane,the likelyhood of invasive growth is presumed to be high

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39
Q 
the doctor requests an hiv and heaptitis test. the laboratory performed both ELISA test and WESTERN BLOT revealing that the latient is HIVpositive,the western blot is used to identify which of the ff?
antibodies
DNA
RNA
proteins
plaque-forming units
A

western blot -proteins
elisa- antibodies

-these two tests are used together,a 99% accurancy rate is achieved

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40
Q 
given rhe px history,if the patient was later diagnosed with active hepatitis, which of rhe ff would most likely be the causative agent?
hepatitis A
hepatitis B
hepatitis C
hepatitis D
hepatitis E
A

hepatitis C

-since 90% of blood transfusion is hepatitis c

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41
Q 
an infection by which the ff bacteria may result in the formation ogf gummas?
mycobacterium tuberculosis
neisseria gonorrhea
treponema pallidum
bordetella pertussis
streptococcus pyogens
A

treponema pallidum

-gummas are seen in tertiary syphilis caused by treponema pallidum

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42
Q 
which of the ff receptors are recognized by CD8 lymphocytes?
class 1 MHC molecules
class 2 MHC molecules
surface IgE
surface IgM
Histamine receptor
A

class 1 MHC molecules

-CD8 recognizes class 1 MHC molecules on antigen presenting cells whille CD4 lymphocytes recognize class 2 MHC molecules on antigen presenting cells

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43
Q 
which of the ff cytokines stimulate B lymphocytes to differentiate into plasma cells?
IL -1
IL -2
IL -3
IL- 4
IL-5
A

interleukin -5 activates eosinophiles and increases the production of IgA

note!
IL-1 ( stimulate cell acrivity or production of mediatorsin a variety of cells including lymphocytes,macrophages,and endothelial cells,the also cause fever)
IL -2 (acrivate helperand cytotoxic t-cells)
IL -3 (stimulate production of RBCs and bone marrow
IL- 4 (stimulate B cell growrh and production of IgE and IgG)

44
Q 
all of the ff symptoms ate mediated by antibodies except?
arthus reaction 
tuberculin reaction
asthma
erythroblastosis fetalis
serum sickness
A

tuberculin reaction

  • is an example of type 4 delayed
  • type 4 is the only hypersensitivity that are not mediated by antibodies.
  • they are mediayed byT- CELLS
45
Q

the dignosis of hemophilia A is made.this ds is caused by deficiency of?

A

factor 8 (antihaemophilic factor)

46
Q

the clinical presentation of haemophilia B is indistinguishable from hemophilia A. which of rhe ff best describes the laboratory method needed to distinguish these two conditions?

A

assay of coagulation factor levels

47
Q 
symptoms of myocardial infarction inclyde all of the ff except one?
angina
diaphoresis (sweating)
fever
vomiting
dyspnea
A

fever (inflamed’something foreign body)

48
Q

the patient is reffered to an infevtios ds spe ialist and placed on “triple therapy”. two years later,the patient is admitted to the emergency room with dry cough and shortness of breath. his tempersture is 101 degrees F. the most likely cause of the patients pneumonia is?

A 
pneumocystiis jiroveci (cariini) 
 -more involved in HIV/AIDS
49
Q 
cafe-aulait spots are seen in junction with polyostotc fibrous dysplasia and endocrine abnormalities in which of the ff disorders?
mcCune- Albrights syndrome
stevens-johnson syndrome
marfans syndrome
gorlin- goltz syndrome
peutz- jeghers syndrome
A

mcCune- Albrights syndrome

  • presents with triad symptoms
    1. polyostotic
    2. café au lait spots
    3. endocrine abnomalities
50
Q 
the patients radiogrph could be describe as having what tupe of characgeristic app?
cotton wool
ground glass
cobweb
soap bubble
starry sky
A

ground glass

  • fibrous dysplasia is a replacement of normal bone with an irregular bone containing fibrous connective tissue.
  • usually describe abnormally shaped trsbeculae in loosely arrange fibrous tissue.
51
Q

the laboratory test results show a normal PT but a prolonged PTT. a prolonged PTTtest suggest that the patient has abnormally affecting which component of coagulation cascade?

A

intrinsic pathway

  • PTT measures intrinsic and xommon pathrways of coagulation cascade.
  • prolinged PTT could result from deficiency of factor 5, 8, 9, 10, 11 or 12 or of prothrombin or fibrinogen
52
Q 
what type of vaccine is used for clostridium tetany?
capsular polysaccharides
toxoids
killed bacteria
immunoglobulins
no vaccine is available
A

toxoids

-it is part of DPT vaccine and should be given about every 10 years

53
Q 
the class of antibuotic thst plays an importsnt role in mucosal immunity is?
IgA
IgD
IgE
IgG
IgM
A

IgA

  • found in musocal area, genitourinary, intestinal and respiratory tracts including tears,saliva nad colustrum.
54
Q 
all of the ff can be found in the cell wall of gram negative bacterium except one?
endotoxin
a thin peptidoglycan layer
lipopolysaccharide
teichoic acid
o antigen
A

teichoic acid

  • found ONLY in the cell walls of gram postive bacteria and contain antigenic properties.
55
Q

which of the ff consost of glucose molecules linked togetherthat act as the structural component of plaque?

A

dextrans
fx: retention of lactic acid near tooth
act as the structural component of plaque
fructans or levans : foubd in plaque that contains fructose

56
Q 
which of the ff groups of microorganism produce dipicolinic acid?
actinomycetes
histoplasma
streptococcus
staphylococcus
clostridium
A

clostridium

note!
dipicolinic acid is Only found in Spores
clostridium is the only spore forming microorganism listed

57
Q 
all of tge ff microbes listed are asso. with infections secondary to an HIV infection exept one.which one is the exeption?
pneumocystis jiroveci (carinii)
epstein-Barr virus
Coxsackievirus
Mycobacterium Tuberculosis
Candida albicans
A

Coxsakie virus

Note!
- all opportunistic infections are seen in patient with AIDS.

58
Q 
Rheumatoid arrhritis is characterized by inflammation of the ?
articular capsule
articular cartilage
cortical bone
perichondrium
synovium
A

sinovium (sinovial membrane)
Note!
-granulation tissue will form in synovium and expand over the articular cartilage ,this causes the destruction of the underlying cartilage and results in fibrotic changes/ankylosis.

59
Q

the most common form of breast cancer is?

A

adenocarcinoma

-arising in ductal epithelium

60
Q

in 2% glutataldehyd,which of the ff times is mininally sufficient for achieving sterilization?

A

12 hrs

61
Q 
an 8 year old boy presents eith macroglossia and delayed eryption of his primary teeth. the ff choices ,which one is most likely?
plummers ds
osteochondroses
cretinism
eilsons ds
mallory-weiss syndrome
A

cretinism
-a hypothyroidism in children

oral findings include:

 - macroglossia
 - prolonged retention of primary teeth
 - delayed eruption of permanent teeth
62
Q

which of the ff bacteria would be xpected to fisrts colonize onto plaque?

A

streptococci (gram positive)

followed by gram negative rod shaped anaerobes

 - bacteroides
 - fusobarterium
 - porphyromonas
 - prevotella
 - actinimycoses
63
Q

which of the ff structures is moat common site for oral cancer?

A 
lower lip (mosby)
lateral border of tge tongue (miks)
64
Q

the presence os Auer rods is an peripheral blood smear suggest which of tge ff conditions?

A

acute myelogenous leukemia

-auer rodes are observe in blast cells,a charctrristic of acute myelogenous leukemia
65
Q 
complications of barrets esophagus include all of the ff..except one.
varices
stricture
hemorrhage (ulceration)
adenocarcinoma
ulceration
A

varices

66
Q 
the presence of M- protein antibodies suggest immunity to infection by which type of bacteria?
Strept. pyogenes
strept. viridans
strept sanguis
staphylococcus aureus
lactobacillus casei
A

strep. pyogenes

- M proteinis impt virulent factor found only in the species Strept. Pyogenes

67
Q 
which of the ff. is usually Least malignant?
acute lymphoblastic leukemia
acute lymphocytic leukemia
acute myelogenous leukemia
chronic lymphocytic leukemia
chronic myelogenous leukemia
A

chronic lymphocytic leukemia

  • a proliferation of B cells
  • Both most common & Least common malignant type of leukemia
68
Q

bronchogenic carcinoma is a complication most characteristic of which of the ff conditions?

A

asbestosis

consequences includes:
-bronchogenic carcinoma and mesothelioma

69
Q

which of the ff disorders is least likely to be included in the differential diagnosis of a patient with jaundice?

A

glumerulonephritis

70
Q 
a productive cough may be seen in all of the ff conditions except one?
pneumonia
lung abscess
bronchiectasis
asthma
bronchogenic carcinoma
A

asthma

  • an obstructive lung ds causes by narrowing of the airways.
  • symptoms include:
    - dyspnea
    - wheezing upon expiration
    - and dry cough
71
Q

antinuclear antibodies are seen in the serum samples from patients with

A

systemic lupus erythematosus (a.k.a lupus)
-characterized by the presence of antinuclear antibodies “ ANA”

-Common ANA findings:
anti-DNA
anti-RNA
anti- Sm antigen

72
Q

nephrolithiasis is most likely to be asso. with which conditions?

A

Hyperpararhyroidism (Ca+)

-due to excessive levels of serum calcium osseos changes,such as metastatic calcifications and kidney stones.

73
Q

an infant diagnosed with osteopetrosis has dysfunctional _______?

A

osteoclast (abnormal)

note!

  • osteopetrosis aka albershonbers ds/marble bone ds
  • results in lack of bine resorptions results in defective bine remideling and increased bone densiry,which invade into into bone marrrow space.
74
Q

t-cell lymphoma is most likely to occur in a patient with which of the ff conditions?

A

celiac sprue

  • characterized by malabsorptuin and mucosal lesion of the small intestine that is caused by allergy in glutein.
  • a complication of this ds includes T-cell lymphomas
75
Q

awhen the sputum samples were taken to the laboratory,what test did the doctor order to be performed to help make diagnosis?

A

acid fast stain

- tuberculosis is caused by mycobacterium tuberculosis.
- this bacteria cannot be gram stained due to their waxy cell walls.
76
Q

after 2 weeks,the bacterial cultures came back from the lab confirming the initial diagnosis,positively identifying the organism M. tuberculosis is known to infect which cells?

A

macrophages

note!
-M. tuberculosis infects macrophages,which are initially unable to kill phagocytosed bacteria.

77
Q

which of the ff is a glycolipid found on the surface of M. Tuberculosis that plays a role in its pathogenesis?

A

cord factor

78
Q

since the px was living in a himeless shelter,the tuberculin test was administered to all of the staff and residents living at the shelter. this test is based on a delayed type hypersensitivity reaction that is mediated by.

A

T- cells and macrophages
note!
-type 4 hypersensitivity reactions are the only type of hypersensitivity that are not mediatedby antibodies.
-they are mediated by T-CELLS

79
Q

which of the ffis rhe most appropriate drug used in combination therapy for tuberculosis to treat patients?

A

RIPES

80
Q

after 3 weeks,the px was feeling “much better and was discharged from the hospital,although he remained on his drug therapy for another 6 months. which of the ff best describes the calcified scar that later formed in the affected lung parynchyma and hilar lymph node?
gumma , chancre , metastatic calcifications , tubercle , ghon conplex

A

Ghon complex

  • a calcified scar that remains following the primary infection
  • it is usually found in the lungs includes primary lesion and regional lymph node
81
Q 
upon further examination ,a heart murmur was detected.given the patients past medical history,which heartvalve is most likely affected?
mitral valve
tricuspid valve 
aortic valve
pulmonary valve
A

mitral valve

  • parients history is Rheumatic fever
  • the heart mumur is most likely from a dysfunctioning mitral valve
  • rheumatic fever most commonly affcets mitral valve
  • resulting to mitral valve stenosis,regurgitation or both
82
Q

before the patient development of rheumatic fever,he likely suffered from which of the ff conditions?

A

pharyngitis

- rheumatic fever is usuallyprecededby a Group A streptococcus respiratory infection (strep throat or pharyngitis)

83
Q

after furtherevaluation and tests,the patient is diagnosed with subacute endocarditis. if the infecting mictobe was cultured in the laboratory,the results would most likely show that thus microbe is positive for?

A

á- hemolysis
-most common acute sub acute endocatditis is strept viridans,an alpha hemolytic streptococci..resulting in incomplete lysis of red blood cells in lsborstory cultures

84
Q 
which of the ff is most likely complication that may occur from the vegetations forming on the px defective heart valve?
myocardial infarction
hemorrhage
petechiae
cor pulmunale
embolus
A

embolus

note!

  • during subacute endocarditis, thrombi formed in previous damage heart valves
  • complications arises if the thrombus embolizes (when the fragment separates and entersthe circulation)
85
Q 
burkits lymphoma is a malignancy that affects which of the ff cells?
macrophages
t lymphocytes
b lymphocytes
neutrophils
keratinocytes
A

b lymphocytes

- burkitts lymphoma is an agressive lymphoma that affects b lymphocytes

86
Q

the pathology report revealsa characteristic pattern of tumor cells that is classically asso with burkitts lymphoma. which of the ff describeshistopathologic patters?

A

staryy sky

-which results from lighter color macrophages present

87
Q

the african form of burkitts lymphoma has bren linked to the epstein barr virus.this virus is also responsible for which of the ff ds?

A

mononucleosis

  • epstein barr virus
  • a ds that also affects b lymphocytes
88
Q

afterthe diagnosisis made,the latient is immediatelyplaced on high dose,IVantibiotics.one of the antibiotics that isadministeredto the patient is streptomycin,an aminoglycoside.the antimicrobial effects of streptomycin is to inhibit the synthesis of?

A

proteins

note!
-aminoglycosides block the 30s ribosomal subunit to inhibitprotein synthesis.

89
Q 
all of the ff factorsplay the role in the virulence of the microbe that causes whooping cough except one,which is tge excemption?
IgA protease
Hemagglutinin
ecotoxin
capsule
pili
A

IgA protease (this enzyme is produced by hemophilus influenzae,another gram negative,rod shaped bacteria)

whooping cough is caused by BORDATELLA PERTUSIS
-all of the ff listed contribute to itsvirulenceexcept IgA protease.

90
Q 
Hemorrhagic infarction ant tissue necrosis suggestwhich of the ff?
aspergillosis
blastomycosis
histoplasmosis
mucormycosis
toxoplasmosis
A

mucormycosis (an infevtion by molds)

note!

- results in invasion og blood vessel endothelium.
 - leads to hemorrhagic infarction ang tissue necrosis
91
Q

the hereditary transmission of Peutz-Jeghers (hereditary ds) syndrome is?

A

autosomal dominant

92
Q

which of the ff may observein a child diagnosedwith rickets?

A

abnornal dentin

note!

  - ricketsis a vitamin D deficiency seen in infants and children  - oral findings include:
 * delayed eruption of permanent teeth
 * abnormal dentin
93
Q

which antimicrobial is bacteriostatic and inhibits protein synthesis in bacteria?

PHARMA

A

tetracycline

94
Q 
rhe presence of which of the ff in a patient serum indicates that the latient is highly infectious hepatitis B carrier?
HBsAg
HBsAb
HBcAg
HBeAg
HBeAb
A

HBeAg

-present when there is active viral replicatiin and tge carrier is highly infectious.

95
Q

a positive quieling reaction can be observe in bacteria with a.

A

capsule

note!
-a qyelling reaction occurs in a laboratory when the polysaccharide capsule of a barterium swells after being treated with antiserum or antibodies.

96
Q 
whuchof the ff is released by mast cells after antigen binding?
IgE
Lysozyme
IL-4
Leukotriene
Interferon
A

leukotriene.

note!
-mast cells contain dense granules with inflammatory mediators,including histamine and SRS-A which is leukotriene.

97
Q 
allof the ff moleculesmay be found within the nucleocapsid of an HIV virus except?
reverse transcriptase
integrase
neuramidase
protease
ribonucleic acid
A

neuramidase ( found in influenza virus)
the rest are:
-the HIV is an RNA virus that contains 3 enzymes.

98
Q

which of the ffwould be the doctor likely prescribe for the patients intraoral infection?

A

nystatin

note!
-oppurtunistic infection are a serious problem with HIV ,the atients intraoral thrush is an infection caused by candida albicans.

99
Q 
an increase in alkaline phosphatasemaybe seen in all of the ff conditions except?
hyperparathyroidism
osteoporosis
osteitis deformans
adenocarcinoma of the prostate
multiple myeloma
A

osteoporosis

  • a ds in bone mass
  • its either normal or decresed alkaline phosphatase in this ds.
100
Q 
all of the ff conditions are commonly asso. with grouo A,Bhemolutic steptococci infection except.
scarlet fever
toxic shock syndrome
pharyngitis
endocarditis
impetigo
A

endocarditis
-most commonly caused by group B,a-hemolytic stteptococci,such as S. viridans, S. mutans, S. sanguis, and S. salivsrius.

101
Q

asso. with rapid tooth eruption

A

hyperthyroidismp

102
Q

asso. with Delayed Tooth Eruption

A 
trisomy 21 (down syndrome)     CPR TT C GGS
cretinism
hypo-thyroidism
hypopituitarism
cleidocranial dysplasia
gingival fibromatosis
gardners syndrome
stergeweber syndrome
rickets
103
Q

px with hemophilia has?

A

normal bleeding time

increased clotting time

104
Q

portal triad

A

portal vein
hepatic duct
hepatic artery

105
Q

capillary with pores? or capillarymost permiable in the liver?

A

hepatic sinusoids

Its not over, Until its over! (19 decks)

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