multisys Flashcards
worsening arthritis of the left knee.
apt 50 sec
BT normal
Pt normal
hemophilia A … factor VIII…. XLR ….
remember factor VII is extrinsic …. PT is more extr
bleeding … normat apt … increased PT
factor VII
Presence of antiphospholipid antibody levels
lupus
vWF disease findings
BT would increase … vWF is used for platelet adhesion
apt increased …. vwf is carrier of factor VIII
prophylaxis for hep b infection is ?
hepb antibodies … which is passive immunization
just like igG from the mother to fetus
passive immunization is used for
To Be Healed Very Rapidly Tetanus Botulism HepB Varicella Rabies
noncoding repetitive neucleotide sequences at the end of the chromosome
telomreres…. maintain chromosomal integrity
AT rich sequences, TATA and CAAT boxes
recognized by RNA polymerase II or other transcription factors leading to transcription
PROMOTERS
gold standard for HCV treatment
ribavirin
side effects of ribavirin
hemolyitic anemia … remember ‘R’ … increased reticulocyte count
what are the signs of hemolytic anemia in blood
when rbc damage… inc LDH…. low haptoglobin levels as the free hb binds to the haptoglobin
immunized hep b pt shows
antiHbs
window hepb
antiHbe and anti HBc IgM
when can minors consent on their own ? <18
sex(birth control, STI, pregnancy)
drugs(substance abuse)
rock n roll ( emerg trauma)
antibiotic that induces DNA damage in anaerobes
metrondazole
antibiotic that inhibits 30s .. food borne illness
shigella
consuming undercooked chicken could lead to infection with
salmonella … but symptms take 12-72 hrs
homocystinuria can be caused by?
cystathione synthase def
vit b6 def
methionine synth def
researcher’s beliefs, in this case in the efficacy of a treatment, changes the outcome of a study.
observer bias
conclusion might be drawn about a population of people who chew gum in order to quit smoking and an increased incidence of lung cancer,
what could be the error?
confounding …. the real cause of cancer would be the smoking
Drugs that inhibit IMP dehydrogenase negatively affect guanine synthesis
hep c drugs like
ribavirin
Guanosine analogues that inhibit viral DNA polymerase
acyclovir
HIV drugs that cause hyperglycemia and lipodystrophy
protease inhibitors … navirs
nucleic acid fragment is added to a tube along with a polymerase, a primer, and deoxyribonucleotides. The tube also contains the four bases as fluorescently labeled dideoxynucleotides. The products in the tube are then run through a capillary, and a laser detects the fluorescence of the products that come out of the capillary
process is called sequencing
tumor suppressor gene on the short arm of chromosome 3
VHL... AD Hemangioblastoma (retina,brainstem,cerebellum,spine) Angiomatosis Renal cell carcinoma Pheo
patient presents with a slowly spreading rash, decreased energy, anorexia, fever, and hepatomegaly.
puppy,child, rash, no allergies
toxocara canis
visceral larva migrans …. increased eosinophils
upregulation of eosinophils in this process is mediated by interleukin
IL 5
JW parents deny blood transfusions for a dying child what do u do
GIVE BLOOD …. parents do not have the authority to deny life saving treatment for their child
A root cause analysis (RCA
identify the causal factors that underlie the failure and identify methods to prevent recurrence
Drug utilization reviews (DURs)
URs serve as a means of improving the quality of patient care, enhancing therapeutic outcomes, and reducing inappropriate pharmaceutical expenditures.
Failure mode and effect analysis (FMEA)
process applied before process implementation to prevent the occurrence of failure
defect in protein tagging in the Golgi complex
I cell disease
no tags means cant be sent to lysosomes so instead they get excerted extracellularly
defects in the breakdown of glycosaminoglycans.
hurler and hunter
hunter has no corneal clouding (iduronate 2 def) XR
hurler (L iduronidase ) def
stranger anxiety and should be able to roll over, hold a sitting position unassisted, pass toys from hand to hand, and babble.
6 months
at 3 months child can
hold head up (devp at 1 mont)
cant roll over or sit
kick a ball and should have a vocabulary of 200 words with the ability to form 2-word sentences. A child at this age should also be climbing stairs
feed himherself with spoon/fork
24 months
arly-onset joint pain and stiffening, skin hyperpigmentation, limited range of motion of the large joints, and a systolic murmur in the aortic area.
alkaptanuria
homogentisate oxidase def …… blocks tyrosine to fumarate pathway
structure(s) is most likely avoided by inserting the needle at the midaxillary line along the upper border of the 10th rib
LUNG
void lung injury, the needle must be inserted into the costodiaphragmatic recess between the 8th and 10th ribs at the midaxillary line.
CCA on tRNA
can carry amino acids ….. AA is covalently bound here to the 3’ end
deficiency in ß-glucocerebrosidase and is most prevalent in members of the Ashkenazi Jewish population
hepatosplenomegaly, aseptic necrosis of the femur, and bone crises.
gaucher
finding in gaucher
crumbles macrophages
mental retardation, cherry-red maculae, and “foamy” macrophages hepatosplenomegaly
neiman pick
n addition to GLUT transporters, utilize SGLT glucose transporters
enterocytes and nephrons
RSA resists β-lactams by
altering PBP … penicillin binding proteins.. transpeptidases
trisomy in downsyndrome happens when
mostly in anaphase of meiosis I or II
heriditary fructose intolerance …
diarrhea … watery
aldolase B def
no cataracts
accum of fructose 1 phosphate … that inhibits gluconeogensis
anti cardiolipin antibodies are found in syphilis … where is cardiolipin found
inner mitochondrial membrane
a useful tool to help guide the root cause analysis
fishbone diagram
opiod toxicity ,,, respiratory acidosis … what is the body’s first reaction to buffer the H+
excess H+ enters cells and binds the intracellular proteins
which step uses biotin in gluconeogenesis
pyruvate to oxaloacetate
antifungal that binds tubulin
griseofulvin
when is RhoGHAM given
it is given to the mother who is RH - with Rh + child … it is to prevent sensitization vs the Rh antigen in the blood
bright red rash 2 days after having a fever, a headache, and diarrhea. He has not had any change in appetite, cough, shortness of breath, or sore throat.
erythematous reticular extensive rash
fifth disease
parvo B19
self limting
pleitrophy
single mutation has diverse effects on different organs example PKU
locus hetrogeneity
different mutations present same phenotype
ex; marfan homocystinuria MEN2B
mean
negative skew
tail of the curve is where the
diabetic mother … child has loud S2 … blood from right ventricle seen in systemic circulation
failure of aorticopulomnary septum to spiral.. transp of greater vessels
defect in septum primum
ASD in down syndrome
hospice care covered by which medicare
A
test of antigen-antibody hybridization that is used to detect an antigenic match in a patient’s blood sample to determine if a person’s immune system has encountered a particular antigen.
Elisa
protein-antibody hybridization to detect protein
westernblt
most abundant form of rna
rrna
young healthy girl ,,, main concern is cheaper monthly insurance plan
HPO
birebeck granules activate which type of immune respnse
they are APC in the skin … they present MHC2 —- activate TH4 cells
APC that present MHC1
and which cells do they activate
MHC 1 is present on all cells except RBC
activate natural killer cells
capping
occurs at the 5’ end of the mRNA - regardless of the sequence - and acts to stabilize the mRNA for export from the nucleus.
transcription
is the process of RNA synthesis from a precursor DNA template
polyadenylation
is the addition of adenosine to the 3’ end of the initial RNA transcript and functions as stability for nuclear export.
a 5’ GU — AG 3’ sequence serves as a site for?
splicing
which blood disorder is affected by splicing
B thalassemia
marathon runner sweats .. what glands and thru stimulation of?
eccrine … thermoregulatory glands… sympathetic stim
influenza vaccine response
humoral response against hemaglutinin
hem helps virus bind cells
how to block an anaphylaxis shock
target immunoglobulin surface receptor
disrupt the cross linking
topical antibiotic form commonly used OTC but not used systemically coz of toxicity
bacitracin
inhibiting translocation of the D-ala-D-ala peptide from inside to outside the bacterial cell.
involves DNA transfer from infection of a virion, which is packaged with DNA from another bacterial cell.
transduction
is a process through which naked purified DNA (DNA outside any cell exposed in the environment) is taken up by bacteria and incorporated into the chromosome.
transformation
muscle biopsy showing deficiency or absence of the enzyme myophosphorylase.
type V mcARDLE
Liver biopsy revealing deficiency of phosphorylas
Hers disease type VI
hepatomegaly and growth retardation
Muscle biopsy showing a deficiency of debranching enzyme
IIIa Cori disease
solely outside skeletal myocytes, including the liver and heart, leading to early symptoms, including hepatomegaly, growth retardation, muscle weakness, hypoglycemia, hyperlipidemia, and elevated liver transaminase levels.
Muscle biopsy revealing a deficiency of lysosomal α-glucosidase
Pompe
glycogen buildup in cardiomyocytes
Muscle biopsy revealing deficiency of phosphoglycerate kinase
muscle weakness, neurological symptosm, anemia
due to decreased pyruvate
enveloped -ssRNA linear virus
child has a rash runny nose cough
rubeola measles
enveloped +ssRNA lineaer virus
Rubella
fever occurs 1-5 days before the rash
gram-negative coccobacillus
bordtella pertusis
ADP ribosylation of Gi
the palmar skin has an additional layer which is it
lucidum
Mutation in the penicillin-binding protein
mechanism of resistance for VANCO
cyclic fever headaches and general weakness.. hepatosplenomegaly after travel
MRI shows cerebral edema and pt has seizures
malaria
p.falciparum has cerebral involvmnt
what is different in inf with p.malaria
more regular 72 hour cycles
the sand fly and may cause spiking fevers and hepatosplenomegaly
leishmania donovani
meeting with all healthcare professionals involved in surgeries to discuss ways to minimize potential errors that would result in harm to the patient.
swiss cheese model
think “S” … system safetyyyy
onvulsions, hyperirritability, peripheral neuropathy and sideroblastic anemia
vitamin def
B6 pyridoxine
adrenal insufficiency along with enteritis and dermatitis
vitamin
B5 Pantothenic acid
cheilosis, corneal vascularisation, and seborrheic dermatitis.
B2 riboflavin
Lipid and membrane biosynthesis
smooth ER
Degradation of cellular material
lysosomes
β-Oxidation of long-chain fatty acids
peroxisome
golgi apparatus
protein modification
defect in the CD40 ligand on CD4 T-helper cells.
hyper IgM syndrome
efect in nicotinamide adenine dinucleotide phosphate oxidase
CGD
increase risk of infc with staph nocardia pseudo listeria
non motile gram negative bacterium
shigella
mechanism of shigella infection
infects M cells in peyers patches
facial features have developed abnormally. hyperactive and aggressive. Physical examination reveals a prominent forehead; an enlarged tongue; hepatosplenomegaly; and several pearly, papular skin lesions over the scapulae, lateral upper arms, and thighs.
Hunter
iduronate sulfatase
rmmber hunters are aggressive***
peripheral neuropathy, angiokeratomas, and hypohidrosis
fabry
alpha galactosidase
oagulase-negative Staphylococcus species, such as S. saprophyticus and S. epidermidis, are associated with infection.
foley catheter
