Multisystem Flashcards
A process in which avoided ideas and emotions are inappropriately transferred to a neutral person or object
Displacement
Immature response
IE angry at ex girlfriend so lashes out at friend
What happens when E. coli is placed on medium only containing lactose?
Allolactose binds to the repressor
Allolactose = inducer; inactivates the reporessor -> increase in cAMP
What bacterial molecule leads a meningococcal pt to have septic shock?
Lipooligosaccharide (LOS)
Endotoxin analogous to LPS but lacks the O-Ag
Stimulates inflammatory cytokines as LPS does leading to septic shock
3 y/o has been hospitalized multiple times for infections including opportunists. He is deficient in a ligand normally expressed on activated CD4+ T cells. Dx?
Hyper-IgM syndrome
X-linked, deficiency in CD40 ligand required for class switching of Ab
Deficiency in IgG with high concentrations of IgM.
Recurrent pyogenic infections and Pneumocystis pneumo.
Tx - IVIG
When a provider projects his or her own thoughts, feelings, past experiences, or issues onto a pt.
Countertransference
Physician doesn’t education pt about payment programs because she is going through a stressful life event and the pt reminds her of her husband.
Reaction in which the pt feels anger toward the physician when the pt’s expectations are not met.
Negative transference
2 significant side effects of ganciclovir?
Myelosuppresion and nephrotoxicity
Requires activation by a viral kinase
Inhibits viral DNA polymerase by acting as a dGTP analogue
What is true in regards to the mean median and/or mode in a positive skew?
Mean > median
What is true in regards to the mean median and/or mode in a negative skew?
Mode > median
Ab secreting plasma cells are rich in which organelle?
RER
Multiple myeloma
Prader Willi and Angelman syndrome are caused by a microdeletion of chromosome 15 and what other mechanism?
DNA methylation
Genetic imprinting - preferential silencing of an allele by a number of mechanism - usually methylation. Others: uniparental disomy, translocation, single gene mutation
Genetic dz characterized by intellectual disability, short stature, obesity, and hypogonadism?
Prader willi
Loss of paternal chr 15
How do you calculate loading dose?
Cp x Vd/F
If a male pt takes clomiphene citrate for infertility, which hormone receptors would be affected?
Estrogen
Selective estrogen receptor modulator that acts as an antiestrogen -> increases secretion of GnRH -> increases testosterone to improve male fertility
More commonly used in female infertility
1 y/o boy has a hx of recurrent infections. He has decreased IgG and no IgM and IgA. Dx and Tx?
Brutons agmmaglobulinemia
IVIG
X linked r, defect in tyrosine kinase (BTK) associated with B cell differentiation. REcurrect bacterial infections that presents around 6 months of age.
Bone marrow transplant is contraindicated b/c T cells are functional
Infant has course facies, FTT, and developmental delay. Fibroblasts are deficient in multiple lysosomal enzymes but these enzymes are found in excess in urine and serum. Dx?
Defect in protein tagging at the Golgi complex
I - cell dz
deficienct in uridine diphospho-N-acetylglucosamine, N-acetylglucosaminyl-1-phosphatase
Normally tag lysosomal enzymes with mannose-6-P in the Golgi
primarily affects mesenchymal cells
Macrophages induce T cell to differentiate into Th1 cells by secreting?
IL-12
Th1 then activates macrophages with IFN gamma
Important defense mechanism in intracellular mechanisms
What increases the melting temp of a DNA strand?
High GC content (3 bonds)
Increased length
Exposure to penicillins, sulfonamides, ethosuximide, and lamotrigine can cause?
Stevens-Johnson syndrome
Urticaria-erythema multiforme-toxic epidermal necrolysis disorder
Begins as erythematous macules -> progress to bullae -> slough off
Mucus membrane involvement is required to dx as Stevens-Johnson syndrome
A cytokine is a potent stimulator of macrophage activity, but not B lymphocyte antibody production. What cells make this?
Th1
Secreates IFN gamma - potent stimulator of macrophages. Also has antitumor and antiviral activity
A pt gets paralytic polio after receiving OPV. LN bx reveals node architecture that lacks germinal centers. How should he be treated?
Regular IM gamma globulin injections
Pt has B lymphocyte deficiency as seen on the bx
A pt gets red man syndrome after initiation of Vanco tx. How could this be avoided?
Slower infusion
Caused by a secondary release of histamine.
Slow 1 to 2 hour infusion of Vanco + antihistamines
How do you treat a pt overdosing on pyridostigmine?
Atropine - muscarinic antagonist
Cholinesterase inhibitor = Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, excitation, lacrimation, sweating, and salivation (DUMBBELSS)
What conditions are associated with Trisomy 21?
Acute Lymphocytic leukemia
Duodenal atresia (double bubble on CXR)
Cardiac septal defects
Alzheimers