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NPLEX I > NPLEX I > Flashcards

NPLEX I Flashcards

1
Q

The femoral artery passes through the adductor hiatus and becomes the _____ artery.

A

Popliteal

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2
Q

At what level of the cervical plexus does the phrenic nerve arise?

A

C3-C5

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3
Q

Which vein originates from the dorsal vein of the great toe and empties into the femoral vein?

A

Great saphenous vein

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4
Q

What is the primary function of the semilunar valves?

A

Prevents back flow into the ventricles during diastole

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5
Q

The presence of Reed Sternberg cells would be indicative of what diagnosis?

A

Hodgkin’s lymphoma

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6
Q

Which artery supplies the temporal artery?

A

External carotid artery

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7
Q

What is the most common cause of congestive heart failure?

A

Atherosclerosis

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8
Q

Where is Angiotensin-converting enzyme primarily located?

A

Capillaries of the lungs

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9
Q

The aortic valve is derived from what embryological structure?

A

Truncus arteriosus

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10
Q

The opening of the left coronary artery is found in what portion of the aortic valve?

A

Left sinus

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11
Q

Which heart valve is most commonly affected in rheumatic heart disease?

A

Mitral valve

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12
Q

On which layer of the heart are vegetations found in cases of rheumatic heart disease?

A

Endocardium

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13
Q

What are the monosaccharides?

A

Glucose, fructose, galactose, mannose

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14
Q

What are the disaccharides?

A

Sucrose
Lactose
Maltose

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15
Q

Sucrose is formed by ____.

A

Glucose + fructose via a1-B2

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16
Q

Lactose is formed by____.

A

Galactose + glucose via B1-4

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17
Q

Maltose is formed by ____.

A

Glucose + glucose via a1-4

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18
Q

Pathogenesis and presentation of xeroderma pigmentosum

A

Defective nucleotide excision repair → inability to repair DNA pyrimidine dimers caused by UV exposure

Presentation: photosensitivity, skin cancer, dry skin

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19
Q

What are the cytoskeletal elements?

A

Microfilaments: actin, microvilli
Intermediate filaments: desmin, neurofliaments
Microtubules: cilia, flagella, mitotic spindle

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20
Q

Which step in collagen synthesis requires vitamin C?

A

Hydroxylation - strengthening of the collagen (proline and lysine residues)

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21
Q

Inheritance pattern of osteogenesis imperfecta

A

Autosomal dominant

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22
Q

Most common gene defect in osteogenesis imperfecta

A

COL1A1 and COL1A2 - leading to a decrease in the production of otherwise normal type I collagen

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23
Q

Pathogenesis of ehlers-danlos syndrome

A

Faulty collagen synthesis

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24
Q

Presentation of Ehlers-danlos syndrome

A

Hyperextensible skin, hypermobile joints, tendency to bleed (easy bruising)

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25
Q

Pheochromocytomas arise from the _____ cells

A

Chromafin

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26
Q

The adrenal medulla mostly secretes which catecholamine into the blood stream during acute stress?

A

Epinephrine

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27
Q

Where is the organ of Zuckerkandl located?

A

Origin of the inferior mesenteric artery

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28
Q

The first rate-limiting step of catecholamine synthesis is catalyzed by which enzyme?

A

Tyrosine hydroxylase

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29
Q

The pituitary gland is seated in the fossa of the sella turcica of the ______ bone.

A

Sphenoid

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30
Q

The anterior pituitary comes from the _____, which is an invagination of the roof of the oral cavity.

A

Rathke pouch

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31
Q

A pheochromocytoma is a tutor that is generally found in which part of the body?

A

Adrenal medulla

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32
Q

What are the cofactors used in the conversion of dopamine to norepinephrine by dopamine beta-hydroxylase?

A

Vitamin C

Copper

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33
Q

Which enzyme is the rate limiting step in the synthesis of catecholamine?

A

Tyrosine hydroxylase

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34
Q

In normal functioning beta cell, insulin secretion is stimulated by membrane depolarization and resultant influx of what ion?

A

Calcium

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35
Q

The blood supply to the tail of the pancreas comes from which artery?

A

Splenic

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36
Q

Where are most of the Calcium ions absorbed in the kidneys?

A

Proximal tubule

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37
Q

Conversion of iodide ions to iodine within the apical membrane of a follicular cell requires what molecule?

A

Hydrogen peroxide

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38
Q

The pancreas is supplied with blood from the _____ and the _____.

A

Celiac trunk

Superior mesenteric artery

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39
Q

Which hormone directly suppresses insulin release?

A

Somatostatin

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40
Q

The pancreas begins to secrete insulin and glucagon by week ____ in a fetus

A

11-20

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41
Q

Which human leukocyte antigen is associated with Hashimoto’s thyroiditis?

A

HLA-DR5

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42
Q

Which artery mainly supplies the proximal duodenum?

A

Inferior mesenteric artery

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43
Q

Mineral corticoids are produced in which part of the adrenal gland?

A

Zona glomerulosa

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44
Q

Where are aldosterone receptors found in the kidney?

A

Distal convoluted tubule and collecting duct

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45
Q

Which type of cells produce stomach acid?

A

Parietal cells

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46
Q

What is the most common complication of GERD?

A

Esophagitis

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47
Q

What is the most serious complication of long-standing GERD?

A

Barrett esophagus

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48
Q

Barrett esophagus is identified by the conversion of distal squamous esophageal epithelium to _____.

A

Columnar epithelium

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49
Q

What are the three divisions of the endoderm?

A

Foregut, midgut, hindgut

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50
Q

The arteries that supply the stomach originate from which artery coming off of the abdominal aorta?

A

Celiac artery

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51
Q

What is the proper order of the layers of the muscular external in the stomach from innermost to outermost?

A

Oblique, circular, longitudinal

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52
Q

What do D cells found in the pyloric glands of the stomach produce?

A

Somatostatin

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53
Q

Function of Somatostatin

A

Inhibits gastrin release from nearby G cells

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54
Q

What are the virulence factors of H. pylori?

A

CagA toxin, urease activity, adhesins

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55
Q

A 36 year old female presents with severe abdominal pain that radiates to her back. Lab report shows increased serum amylase and hypocalcemia. The patient is diagnosed with acute pancreatitis. What is the cause of her hypocalcemia?

A

Calcium deposition in fatty acid-calcium soaps

Acute pancreatitis is associated with fat necrosis in which the enzyme lipase releases fatty acids from TG’s. These fatty acids then complex with calcium to form soaps thereby lowering calcium levels.

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56
Q

The pancreas receives parasympathetic signals from which nerve?

A

Vagus

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57
Q

The pancreas receives sympathetic signals from which nerve?

A

Splanchnic

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58
Q

Which pancreatic cells secrete enzymes?

A

Acinar cells

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59
Q

Which hormone is released in response to consumption of proteins and fats and stimulates the release of enzymes?

A

Cholecystokinin

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60
Q

What is the only muscle that is innervated by cranial nerve 9 - that lies in the oropharynx?

A

Stylopharyngeus

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61
Q

In the enteric nervous system, what is the submucosal (Meissner’s) plexus responsible for?

A

Blood flow and secretion

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62
Q

In the enteric nervous system, what is the myenteric (Auerbach’s) plexus responsible for?

A

Motility

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63
Q

The anterior ligament that separates the left from the right lobe of the liver is known as the _____.

A

Falciform ligament

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64
Q

What type of cells lines the esophagus?

A

Stratified squamous cells

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65
Q

What cellular changes are seen in Barrett esophagus?

A

Metaplasia of the lower esophageal epithelium - complete replacement of the stratified squamous cells with columnar epithelium

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66
Q

What nucleus within the medusa oblongata controls swallowing?

A

Solitary

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67
Q

Which nerve provides the primary innervation for the esophagus?

A

Vagus (recurrent laryngeal branches)

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68
Q

Which transporter is involved with fructose absorption in the intestine?

A

GLUT5

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69
Q

Which lactate dehydrogenase enzyme is elevated in liver failure?

A

LDH-5

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70
Q

Which vessel delivers blood to the liver?

A

Portal vein

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71
Q

Which part of the intestinal system does celiac disease effect?

A

Duodenum and jejunum

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72
Q

Lymphatics from the appendix drain directly into the _____ lymph nodes

A

Ileocolic

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73
Q

What is the first rate-limiting and committing step in bile acid synthesis?

A

7 alpha-hydroxylase

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74
Q

The common bile duct is formed by the union of the ____ duct and the ____ duct.

A

Cystic, hepatic

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75
Q

Which gene is associated with polycythemia vera?

A

JAK2

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76
Q

What is the key regulatory enzyme of heme synthesis?

A

ALA synthase

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77
Q

Which interleukin is needed to form B lymphocytes from their lymphoid progenitors?

A

IL-7

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78
Q

Rheumatoid arthritis is considered a _______ hypersensitivity reaction.

A

Type III

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79
Q

How many sesamoid bones

A

3

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80
Q

Which muscle abducts digits, flexes the metacarpophalangeal joints and extends interphalangeal joints in the 2nd digit?

A

Dorsal interossei

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81
Q

Which joint change is common in rheumatoid arthritis?

A

Boutonniere deformity

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82
Q

Most common causative organism of acute and chronic pyogenic osteomyelitis in children and adults.

A

Staphylococcus aureus

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83
Q

Which nerve innervates the extensor hallucis breves muscle?

A

Deep peroneal nerve

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84
Q

Which amino acid is the primary donor of the nitrogen atoms that make up urea?

A

Glutamate

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85
Q

Which posterior crural muscle connects to the posterior head of the fibula and calcaneus?

A

Soleus

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86
Q

Inheritance pattern of Marfan syndrome

A

Autosomal dominant

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87
Q

Pathology of Marfan syndrome

A

Connective tissue disease affects the heart, skeleton and eye - FBN1 gene mutation on chromosome 15 = defective fibrillin-1

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88
Q

Inheritance pattern of cystic fibrosis

A

Autosomal recessive - defect in CFTR gene on chromosome 7

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89
Q

Pathophysiology of cystic fibrosis

A

CFTR encodes for Cl channel that secretes Cl in lungs and GI tract → gene defect = misfolded protein → CFTR protein absent from cell membrane → decreased Cl secretion → increased intracellular Cl → compensatory increase in sodium → increased water → abnormally thick mucus secreted into lungs and GI tract

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90
Q

Common findings in cystic fibrosis

A

Recurrent pulmonary infections, chronic bronchitis and bronchiectasis, pancreatic insufficiency, malabsorption with steatorrhea, fat soluble vitamin deficiencies, meconium ileum in newborns, infertility in males

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91
Q

What leads to infertility in males with cystic fibrosis?

A

Absence of vas deferens

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92
Q

Most common microbes leading to recurrent infections in patients with cystic fibrosis

A

Children: S. aureus
Adults: P. aeruginosa

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93
Q

Inheritance pattern of Duchenne muscular dystrophy

A

X-linked recessive

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94
Q

Pathophysiology of Duchenne muscular dystrophy

A

Deleted dystrophin protein → dystrophin helps anchor muscle fibres, primarily in the skeletal and cardiac muscle

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95
Q

Inheritance pattern of fragile X syndrome

A

X-linked dominant inheritance

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96
Q

What organs does the digestion of fat soluble vitamins depend on?

A

Ileum and pancreas

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97
Q

What type of anemia is caused by vitamin B12 deficiency?

A

Macrocytic, megaloblastic anemia

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98
Q

Vitamin K is necessary for the maturation of which clotting factors?

A

II, VII, IX, X, proteins C and S

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99
Q

Where is ethanol converted to acetaldehyde?

A

Cytosol

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100
Q

Where is acetaldehyde converted to acetate?

A

Mitochondria

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101
Q

Which enzyme converts ethanol to acetaldehyde in ethanol metabolism?

A

Alcohol dehydrogenase

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102
Q

Which enzyme converts acetaldehyde to acetate in ethanol metabolism?

A

Acetaldehyde dehydrogenase

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103
Q

Rate limiting enzyme of glycolysis and its controls

A

Phosphofructokinase 1
Activated: AMP, fructose 2,6 bisphosphate
Inactivated: ATP, citrate

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104
Q

Rate limiting enzyme of gluconeogenesis and its controls

A

Fructose 1,6 bisphosphatase 1

Inactivated: AMP, fructose 2,6 bisphosphate

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105
Q

Rate limiting enzyme of TCA cycle and its controls

A

Isocitrate dehydrogenase
Activated: ADP
Inactivated: ATP, NADH

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106
Q

Rate limiting enzyme of glycogenesis and its controls

A

Glycogen synthase
Activated: insulin, cortisol, G6P
Inactivated: epinephrine, glucagon

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107
Q

Rate limiting enzyme of glycogenolysis and its controls

A

Glycogen phosphorylase
Activated: epinephrine, glucagon, AMP
Inactivated: G6P, insulin, ATP

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108
Q

Rate limiting enzyme of HMP shunt and its controls

A

G6PD
Activated: NADP
Inactivated: NADPH

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109
Q

Rate limiting enzyme of urea cycle and its controls

A

Carbamoyl phosphate synthetase I

Inactivated: N-acetylglutamate

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110
Q

Rate limiting enzyme of FA synthesis and its controls

A

Acetyl-CoA carboxylase
Activated: insulin, citrate
Inactivated: glucagon, palmitoyl-CoA

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111
Q

Rate limiting enzyme of FA oxidation and its controls

A

Carnitine acyltransferase I

Inactivated: malonyl-CoA

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112
Q

Rate limiting enzyme of ketogenesis and its controls

A

HMG-CoA synthase

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113
Q

Rate limiting enzyme of cholesterol synthesis and its controls

A

HMG-CoA reductase
Activated: insulin, thyroxine, estrogen
Inactivated: glucagon, cholesterol

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114
Q

How many ATP are produced from one glucose molecule in aerobic metabolism?

A

32 via heart and liver

30 via muscle

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115
Q

How many ATP are produced from one glucose molecule in anaerobic metabolism?

A

2 ATP

116
Q

During embryogenesis where do melanocytes originate from?

A

Neural crest

117
Q

What is the most common type of mutation produced by UV irradiation that may lead to melanoma?

A

Cyclobutane pyrimidine dimer

118
Q

UVB converts 7-dehydrocholesterol into ______ within the skin

A

Cholecalciferol

119
Q

Name the endogenous pyrogens

A

IL-1, IL-6, TNF-alpha

120
Q

______ is produced by T-cells to inhibit viral replication

A

Interferon

121
Q

Pemphigus vulgaris is an autoimmune attack on ______.

A

Desmoglein

122
Q

Which amino acid can increase herpes simplex viral breakouts?

A

Arginine

123
Q

What organism causes most boils, carbuncles and impetigo?

A

Staphylococcus aureus

124
Q

The epidermis is formed from which embryological germ layer?

A

Ectoderm

125
Q

What is the embryological origin of melanocytes?

A

Neural crest cells

126
Q

During wound healing, which mineral is necessary for the enzymatic cross linking of collagen in the extracellular matrix?

A

Copper

127
Q

What is the normal skin pH?

A

Ranges between 4-6

128
Q

What type of hypersensitivity reaction is allergic contact dermatitis?

A

Type IV delayed type hypersensitivity

129
Q

What are the two phases in the development of delayed hypersensitivity reactions?

A

sensitization and elicitation

130
Q

Melanocytes are located in which layer of the epidermis?

A

Stratum basale

131
Q

Which type of collagen fibres accumulate in the tissues in cases of scleroderma?

A

Type III

132
Q

Which enzyme is responsible for the cross linking of collagen and elastin fibres?

A

Protein-lysine 6-oxidase

133
Q

What cofactors does protein-lysine 6 oxidase use?

A

copper and vitamin C

134
Q

Langer’s lines of tension in the skin are found in what layer of the dermis?

A

Reticular layer

135
Q

Wilm’s tumor is associated with mutations in the WT1 gene on which chromosome?

A

11

136
Q

Where are podocytes located?

A

Bowman’s capsule

137
Q

Where are the renal pyramids located in the kidney?

A

Medulla

138
Q

What are the most common epithelial cells lining the prostate gland?

A

Simple columnar or cuboidal and they may look pseudostratefied

139
Q

Which nerve cell supplies myelin?

A

Oligodendrocytes and Schwann cells

140
Q

Which cranial nerve is involved in diplopia associated with MS?

A

CN 6

141
Q

What is the order of flow of CSF from its origin to the point at which it enters the bloodstream?

A

Choroid plexus, lateral ventricle, third ventricle, cerebral aqueduct, fourth ventricle, subarachnoid space, arachnoid villi, dural venous sinuses

142
Q

The middle meningeal layer that envelopes the brain and spinal cord is called the ______.

A

Arachinoid mater

143
Q

What structure allows CSF to exit the sub-arachnoid space and enter the bloodstream?

A

Arachnoid villi

144
Q

Wilson’s disease is an _______ genetic disease of _______ metabolism.

A

Autosomal recessive

Copper

145
Q

Which protein is deficient in Wilson’s disease?

A

Ceruloplasmin

146
Q

When EPS symptoms occur, which part of the brain is damaged?

A

Basal ganglia

147
Q

Which gyrus is located in the posterior parietal lobe?

A

Angular

148
Q

In what layer of the epithelium are the ceruminous glands found?

A

Dermis

149
Q

What event occurs when the cilia on the hair cells of the Organ of Corti bend?

A

Opening of potassium channels within the hair cells

150
Q

Where does the first synapse and subsequent decussation occur within the auditory pathway?

A

Cochlear nuclei of the medulla

151
Q

Where are the neurofibrillary tangles primarily found in the brain?

A

Cerebral cortex

152
Q

The hippocampus is located in the ______ lobe of the brain.

A

Temporal

153
Q

What is the role of acetylcholine transferase?

A

Combines choline and acetyl-CoA in the cytoplasm to form acetylcholine

154
Q

What is the role of acetylcholinesterase?

A

Degrades acetylcholine into choline and acetate

155
Q

What brain cell type is responsible for relaying nutrients from the bloodstream to the neuron?

A

Astrocytes

156
Q

At what level does the spinal cord terminate?

A

L2

157
Q

What is the most frequent cause of intracranial hemorrhage?

A

Hypertension

158
Q

The internal aspect of the tympanic membrane is covered by what type of epithelium?

A

Cuboidal epithelium

159
Q

The epithelial lining of the auditory tubes is derived from what germ cell layer?

A

Endoderm

160
Q

The fluid balance of the ear is very delicate. The endolymph is ____ rich while the perilymph is ____ rich.

A

K+, Na+

161
Q

ALS involves the degeneration of the _____.

A

Upper and lower motor neurons

162
Q

Which nerve innervates the biceps brachii muscle?

A

Musculocutaneous nerve

163
Q

Which nerve innervates the triceps brachii and ancones muscles?

A

Radial nerve

164
Q

Which nerve innervates the deltoid and theres minor muscles?

A

Axillary nerve

165
Q

90% of the corticospinal fibres cross over in which area to form the lateral corticospinal tract?

A

Caudal medullary pyramids

166
Q

The patellar DTR tests which spinal nerve root?

A

L4

167
Q

The biceps DTR tests which spinal nerve root?

A

C5, C6

168
Q

The brachioradialis DTR tests which spinal nerve root?

A

C6

169
Q

The triceps DTR tests which spinal nerve root?

A

C7

170
Q

The achilles DTR tests which spinal nerve root?

A

S1

171
Q

Which fissure separates the middle lobe from the lower lobe in the right lung?

A

The oblique fissure

172
Q

Which vessels supply the lung tissue with oxygenated blood?

A

The bronchial arteries

173
Q

Where is the cardiac notch located?

A

Anteroinferior edge of the left superior lobe of the lung

174
Q

What are the only arteries in the blood that carry deoxygenated blood?

A

Pulmonary arteries

175
Q

How many cartilages does the larynx have?

A

9

176
Q

What cofactor does nitric oxide require in its synthesis?

A

Biopterin

177
Q

Which prostate zone contains the main glands?

A

Peripheral

178
Q

The prostate produces _______ to liquefy coagulated semen to enable the sperm to swim

A

Fibrinolysin

179
Q

The penis receives innervation from ____ spinal segments via the pudendal nerve and pelvic plexi

A

S2-S4

180
Q

The glans penis is a distal expansion of the ______.

A

Corpus spongiosum

181
Q

LH is secreted by the ______, and stimulates ovarian ______.

A

Anterior pituitary

Theca cells

182
Q

What stimulates spermatogonia and leads to the formation of primary spermatocytes?

A

FSH

183
Q

The spermatozoa travel from the ____ to the efferent ductules.

A

Rete testis

184
Q

What begins to guide the testes down through the inguinal canals and facilitates their migration?

A

Gubernacula

185
Q

Which ligament pulls the fundus of the uterus anteriorly?

A

Round ligament

186
Q

What ligament attaches the ovaries to the lateral abdominal walls?

A

Suspensory ligament

187
Q

The kidneys are located between which spinal levels?

A

T11-L3

188
Q

Glucokinase phosphorylates glucose to glucose-6-phosphate in the _____ and is inhibited by ______.

A

Liver

Fructose 6 phosphate

189
Q

Hexokinase phosphorylates glucose to glucose-6-phosphate in the ______ and is inhibited by _____.

A

Most tissues except liver

Glucose 6 phosphate

190
Q

Glycolysis occurs in the ______.

A

Cytoplasm

191
Q

Glucokinase is inhibited by ________.

A

Fructose 6 P

192
Q

Hexokinase is inhibited by ______.

A

Glucose 6 P

193
Q

Anaerobic glycolysis yields ______.

A

Lactate

194
Q

Aerobic glycolysis yields _______.

A

Acetyl CoA

195
Q

Glucagon _______ blood glucose

A

Increases

196
Q

Insulin _______ blood glucose

A

Decreases

197
Q

Which mitochondrial enzyme links glycolysis and the TCA cycle?

A

Pyruvate dehydrogenase

198
Q

Which enzyme shares the same cofactors as pyruvate dehydrogenase?

A

a-ketoglutarate dehydrogenase

199
Q

Effects of pyruvate dehydrogenase deficiency

A

Build up of pyruvate (because it can’t enter the TCA as Acetyl CoA) → build up of lactate and alanine → neurological deficits, increase serum alanine, lactic acidosis

200
Q

Location of TCA cycle

A

Mitochondria

201
Q

a-ketoglutarate cofactors

A

B1, lipoid acid, B5, B2, B3

202
Q

Location of electron transport chain

A

Inner mitochondrial membrane

203
Q

FADH2 electrons are transferred to complex ____ in the electron transport chain

A

II

204
Q

NADH electrons are transferred to complex ____ in the electron transport chain

A

I

205
Q

What are the 4 enzymes unique to gluconeogenesis and where are they located?

A

Pathway Produces Fresh Glucose

Pyruvate carboxylase (mitochondria)
Phosphoenolpyruvate carboxykinase (cytosol)
Fructose 1,6 bisphosphatase 1 (cytosol)
Glucose 6 phosphatase (ER)

206
Q

Location of HMP shunt

A

Cytoplasm

207
Q

The oxidative phase of the HMP shunt yields _____.

A

NADPH

208
Q

The non oxidative phase of the HMP shunt yields _____.

A

Ribose

209
Q

Pathophysiology of glucose 6 phosphate dehydrogenase deficiency

A

Glucose 6 phosphate dehydrogenase is the rate limiting step of the HMP shut → deficient G6PD → reduced NADPH → decreased ability to reduce glutathione and detoxify free radicals and peroxides → red blood cell oxidative damage → hemolytic anemia

210
Q

Most common human enzyme deficiency

A

G6PD deficiency

211
Q

Inheritance pattern of G6PD deficiency

A

X-linked recessive

212
Q

A patient has fructose appearing in their blood and their urine, what enzyme is responsible for this pathology?

A

Fructokinase

213
Q

An infant presents with cataracts, galactosemia and galactosuria, what enzyme deficiency is responsible for this condition?

A

Galactokinase deficiency

214
Q

Pathophysiology of galactokinase deficiency

A

Hereditary deficiency of galactokinase → inability to convert galactose to galactose 1-P → accumulation of galactose and build up of galactitol

215
Q

Glucose is converted to sorbitol via _______.

A

Aldose reductase

216
Q

Location of urea cycle

A

Mitochondria and cytoplasm

217
Q

What is the most common genetic cause of increased ammonia levels?

A

Ornithine transcarbamylase deficiency

218
Q

Inheritance pattern of ornithine transcarbamylase deficiency

A

X linked recessive

219
Q

Inheritance pattern of phenylketonuria

A

Autosomal recessive

220
Q

Excess glucose is stored as _______ in skeletal muscles and liver cells.

A

Glycogen

221
Q

Glycogen branches have _____ bonds, while it’s linkages have _____ bonds.

A

a 1-6

a 1-4

222
Q

Where does fatty acid synthesis primarily occur?

A

Lactating mammary glands, liver, adipose tissue

223
Q

Ketone bodies are primarily formed from ____ and _____.

A

Fatty acid synthesis + Amino acids → Acetyl CoA

224
Q

What are the three ketone bodies in the blood?

A

Acetone, acetoacetate, B-hydroxybutyrate

225
Q

What are the primary immune organs?

A

Bone marrow

Thymus

226
Q

What are the secondary immune organs?

A

Spleen, lymph nodes, tonsils, Peter patches

227
Q

What are the functions of the lymph node?

A

Nonspecific filtration by macrophages
Circulation of B and T cells
Immune response activation

228
Q

What are the 3 sections of the lymph node?

A

Follicle
Medulla
Paracortex

229
Q

What area of the lymph node is responsible for B cell localization and proliferation?

A

Follicle

230
Q

What area of the lymph node contains T cells?

A

Paracortex

231
Q

Which section of the lymph node enlarges to present as lymphadenopathy?

A

Paracortex

232
Q

Where are the B cells found in the spleen?

A

Follicle of the white pulp

233
Q

Where are the T cells found in the spleen?

A

Periarteriolar lymphoid sheath of the white pulp

234
Q

Where are the macrophages and specialized B cells found in the spleen?

A

Marginal zone

235
Q

What is the embryological origin of the thymus?

A

Third pharyngeal pouch (endoderm)

236
Q

The cortex of the thymus contains _______ T cells, whereas the medulla of the thymus contains ______ T cells.

A

Immature

Mature

237
Q

Lymphocyte and neutrophil status in acute viral infection

A

Increased lymphocytes

Decreased neutrophils

238
Q

Lymphocyte and neutrophil status in chronic viral infection

A

Decreased lymphocytes

239
Q

Lymphocyte and neutrophil status in acute bacterial infection

A

Increased neutrophils

Decreased lymphocytes

240
Q

Lymphocyte and neutrophil status in chronic viral infection

A

Decreased neutrophils

241
Q

Which HLA subtype is associated with Celiac’s disease?

A

DQ2/DQ8

242
Q

Which HLA subtype is associated with Hashimoto’s thyroiditis?

A

DR3

243
Q

Which HLA subtype is associated with rheumatoid arthritis?

A

DR4

244
Q

Function of NK cells

A

Use perforin and granzymes to induce apoptosis

245
Q

Which interleukins enhance the activity of NK cells?

A

IL2, IL12, IFNa and IFNB

246
Q

Fever pathway

A

Pyrogen → IL-1 → Hypothalamus → COX → Prostaglandins → Fever

247
Q

Function of Th1

A

Secretes IFNy and IL-2 to activate macrophages and cytotoxic T cells

248
Q

Function of Th2

A

Secretes IL4, IL5, IL6, IL10, IL13 to activate eosinophils and increase IgE

249
Q

Function of Th17

A

Secretes IL17, IL21, IL22 to induce neutrophilic inflammation

250
Q

Function of Treg

A

Secretes TGFB, IL10, IL35 to prevent autoimmunity

251
Q

Which cytokines are anti-inflammatory?

A

TGFB, IL10

252
Q

What are the 3 ways that an antibody protects against a pathogen ?

A

Neutralization: antibody prevents bacterial adherence
Opsonization: antibody promotes phagocytosis
Complement activation: antibody activates complement, enhancing opsonization and lysis

253
Q

Which immunoglobulin is the most abundant isotope in the serum?

A

IgG

254
Q

Which immunoglobulin crosses the placenta to provide infants with passive immunity?

A

IgG

255
Q

Which immunoglobulins fix complement?

A

Fc portion of IgM and IgG

256
Q

Where is IgA produced?

A

GI tract

257
Q

What is the most produced antibody overall?

A

IgA

258
Q

What is the first B cell product to an infection?

A

IgM

259
Q

MAC will defend agains gram ____ bacteria.

A

Negative

260
Q

Which are the “acute” cytokines?

A

IL-1, IL-6, TNF-a

261
Q

Which cytokines are produced from macrophages?

A

IL-1, IL-6, TNF-a, IL-12, IL-8

262
Q

Which cytokines are produced from T cells?

A

IL-2, IL-3

263
Q

What cytokines are produced from Th1 cells?

A

IFN-y

264
Q

What cytokines are produced from Th2 cells?

A

IL-4, IL-5, IL-10, IL-13

265
Q

Which gene is defected in x-linked agammaglobinemia?

A

BTK gene → no B cell maturation

266
Q

Gene effected in DiGeorge syndrome

A

22q11 micro deletion

267
Q

What are the defects in SCID?

A

Defective IL-2R gamma chain (most common)
Adenosine deaminase deficiency
RAG mutation → VDJ recombination defect

268
Q

Which microorganisms are facultative anaerobes?

A

Staphylococcus, streptococcus, enteric gram - bacterial

269
Q

Which microorganisms are obligate intracellular?

A

Rickettsia, Chlamydia, Coxiella

Obligate intracellular pathogens stay inside (cells) when it’s Really CHilly and COld

270
Q

Which microorganisms are facultative intracellular?

A

Salmonella, Neisseria, Brucella, Mycobacterium, Listeria, Francisella, Legionella, Yersinia pestis

Some Nasty Bugs May Live FacultativeLY

271
Q

Which microorganisms are encapsulated?

A

Please SHiNE my SKiS

Pseudomonas aeurginosa, Streptococcus pneumonia, Haemophilus influenza type B, Neisseria meningitides, Escherichia coli, Salmonella, Klebsiella pneumonia, group b Strep

272
Q

How are microorganisms with capsules cleared by the body?

A

Opsonized and cleared by the spleen

273
Q

Which microorganisms are urease positive?

A

Pee CHUNKSS

Proteus, Cryptococcus, H pylori, Ureaplasma, Nocardia, Klebsiella, S epidermidis, S saprophyticus

274
Q

What component is part of a spores core and how does it contribute to virulence?

A

Dipicolinic acid - responsible for heat resistance

275
Q

Differences between exotoxin and endotoxin

A

Exotoxin is produced and released by the bacteria into the extracellular environment, it comes from gram + and gram - bacteria, high fatal dose

Endotoxin is a physical component of the bacterial cell, mostly gram - bacteria, low toxicity

276
Q

Which component of LPS is toxic?

A

Lipid A

The other components are O-antigen and core polysaccharide

277
Q

What are the 3 main effects of Endotoxins?

A

Macrophage activation: Fever, hypotension
Complement activation: releasing histamine, hypotension, edema, neutrophil chemotaxis
Tissue factor activation: coagulation cascade (DIC)

278
Q

What is the only bacteria that is coagulase +?

A

S. aureus

279
Q

What is the most common cause of UTI?

A

E. coli

280
Q

What is the second most common cause of UTI?

A

S. saprophyticus

281
Q

What does the anthrax toxin consist of?

A

Protective factor
Lethal factor
Edema factor

282
Q

Which E. coli doesn’t ferment sorbitol?

A

EHEC

283
Q

What is the most common serotype of EHEC?

A

O157:H7

284
Q

What is the triad of symptoms for hemolytic uremic syndrome?

A

Anemia
Thrombocytopenia
Acute kidney injury

285
Q

Which toxin causes hemolytic uremic syndrome?

A

Shiga toxin

286
Q

Which bacteria are spirochetes?

A

Leptospira
Treponema
Borrelia

287
Q

A rash on the palms and soles is seen in which infections?

A

Coxackievirus A (hand, foot and mouth), Rocky Mountain spotted fever, Secondary syphilis (you drive CARS using your palms and soles)

NPLEX I (1 decks)

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