Quiz 54 Flashcards
What is the cause of an annular pancreas?
Abnormal embryological rotation of the pancreatic bud
What is seen radiologically in chronic pancreatitis?
Pancreatic calcification - small opacities in the upper abdomen
Chronic pancreatitis can result in what endocrine disorder?
Diabetes mellitus
Rupture of bridging veins results in what type of brain bleed?
Subdural hematoma
Rupture of Charcot-Bouchard aneurysms produce hemorrhage where?
Intraparenchymal hemorrhage - commonly in the basal ganglia
Rupture of middle meningeal artery causes what type of brain bleed?
Epidural hematoma
Where can one find aneurysms in ADPKD?
Circle of Willis
Histologic evaluation of a lymph node showing mixture of cells (lymphocytes, histiocytes, eosinophils, and plasma cells) with scattered, large cells with prominent nucleoli is found in what disease?
Hodgkins lymphoma
What disease causes lymph node architecture to be distorted by broad bands of fibrosis?
Nodular sclerosing subtype of Hodgkins lymphoma
What subtype of cells are seen in nodular sclerosing Hodgkins lymphoma?
Subtype of Reed-Sternberg cells called lacunar cells
Chronically high venous pressure in the legs can result in what?
Varicose veins
In late stages of AIDs, what antibodies are not produced? Why?
IgG, IgA, and IgE are not produced - these antibodies need T-cell help
What bacterium is gram positive, grows in clusters and is non-hemolytic?
Staphylococcus epidermidis
What is the morphology of S. aureus? What type of hemolysis does it produce?
Gram positive cocci; catalase and coagulase +; beta-hemolytic
Gram positive cocci that ferments mannitol?
S. Aureus
Is S. pyogenes bacitracin sensitive or resistant? Hemolysis?
Sensitive; beta-hemolytic
What is the morphology of S. epidermidis? How is it differentiated from S. aureus?
Gram + cocci in clusters; catalase + but coagulase negative; also is gamma hemolytic
What is a distinguishing feature of S. epidermidis?
Novobiocin sensitive; biofilm producer
Gram positive cocci, catalase and coagulase negative, beta hemolytic, bacitracin resistant and CAMP+
S. Agalactiae
Gram positive cocci, catalase +, coagulase negative, novobiocin sensitive
S. Epidermidis
How does one differentiate between staph aureus, epidermidis, and saprophyticus?
All are catalse +, epidermidis and saprophyticus are coagulase negative and gamma-hemolytic; epidermidis is novobiocin sensitive and saprophyticus is novobiocin resistant
Acquired pure red cell aplasia is seen after infections with what?
Parvovirus B19
Patients with what disease(s) are prone to developing pure red cell aplasia?
Sickle cell anemia or hereditary spherocytosis
What anticonvulsant drugs can cause aplastic anemia?
Carbamazepine and phenytoin
What antibiotic can cause aplastic anemia?
Chloramphenicol
Bernard-Sloulier syndrome is due to absence of what?
Platelet Glycoprotein Ib, a receptor for vWF
What syndrome does one see thrombocytopenia, frequent infections, and eczema?
Wiskott-Aldrich syndrome
Increasing the survival of a certain disease does what to incidence and prevalence?
Incidence is normal, but prevalence increases
Primary prevention does what to incidence and prevalence?
Both decrease
Increased death from a certain disease does what in incidence and prevalence?
Incidence in normal (stays the same), but prevalence decreases
Cart-wheel distribution of chromatin in the nucleus is seen in infections with what organism?
Entamoeba histolytica
Entamoeba histolytica causes what symptoms?
Diarrhea (can be bloody), peritonitis and liver abscess formation
What is seen in the stool of a patient infected with Entamoeba histolytica?
Cysts or trophozoites
Mumps is part of what viral family? What is its genetic makeup?
Paramyxoviridae; -ssRNA
How do paramyxoviruses evade the immune system? What type of immunity is thus important?
Evade by syncytia formation (spread from cell to cell this way); cell mediate immunity is important as antibodies (humoral immunity) don’t “see” the virus
What viruses are part of paramyxoviridae?
RSV, parainfluenza (croup), mumps, measles,
How does one treat RSV?
Ribavirin
What bacterial species undergo natural transformation? (4 of them)
Haemophilus spp. Streptococcus spp., Neisseria spp., H. Pylori
What is natural transformation?
Uptake of naked DNA from the environment
Meconium ileus is often the first manifestation of what disease?
Cystic fibrosis
What is meconium ileus?
Thick, sticky meconium obstructs the intestine - most commonly occurs at the ileus
Meconium ileus can result in what complications?
Perforation with peritonitis and intraperitoneal calcification
Deposition of what causes senile cardiac amyloidosis?
Transthyretin
Autoimmune disease can result in deposition of what type of amyloid?
Amyloid associated protein
Long term hemodialysis results in what type of amyloid deposition?
Beta-2 microglobulin
Antibodies that recognize metalloprotease that cleaves vWF multimers results in what disease?
Thrombotic thrombocytopenic purpura
What is the common pentad of thrombotic thrombocytopenic purpura?
Fever, thrombocytopenia, microangiopathic hemolytic anemia, renal insuff., neurological manifestations
*pentad rarely seen
What is ADAMTS-13?
Metalloprotease that cleaves ultralarge vWF multimers
Deficiency in ADAMTS-13 results in what disease?
Thrombotic thrombocytopenia purpura
In thrombotic thrombocytopenic purpura, what is seen on peripheral smear?
Schistocytes due to microangiopathic anemia
What cardiac abnormality is seen in infections of Borrelia burgdorferi?
AV block
Cheese, beer, and wine cause interaction with what drugs?
Tyramine containing foods (beer, cheese, wine) cause interactions with monoamine oxidase inhibitors
List three MAO inhibitors.
Phenelzine, tranylcypromine, isocarboxazid
What happens when a patient is on MAO inhibitors and tyramine containing foods are ingested?
Large amounts of NE are displaced from postganglionic neurons, resulting in sympathetic crisis
What happens to the numerical density and total luminal cross sectional area of blood vessels in high blood pressure?
Decreased numerical density and decreased cross sectional area
What is a common cause of neonatal meningitis?
Streptococcus agalactiae (GBS)
What is the morphology of S. agalactiae? Is it bacitracin sensitive or resistant?
Gram positive cocci, bacitracin sensitive
What cytoskeletal protein moves toward the plus end of microtubules? Which toward the minus end of microtubules?
Kinesin moves toward the plus end; dynein moves toward the minus end
Anterograde transport involves what cytoskeletal protein? Is it toward the minus or plus end of microtubules?
Anterograde is toward the plus end and involves kinesins
Are myosins directed toward the plus or minus end of microtubules?
Plus end
What lab values are important in diagnosing DIC?
Prolonged PT and PTT, decreased fibrinogen level and elevated fibrin split products
Crescent-shaped protozoa adjacent to epithelial brush border on biopsy is characteristic of what infection?
Giardia lamblia
After swimming in fresh water, patient complains of losing sense of smell and now has a prefrontal headache with fever and nausea, what organism are they infected with?
Naegleria fowleri
How is a diagnosis of Naegleria fowleri meningoencephalitis made?
Trophozoites in CSF
Thymic hyperplasia and thymomas are strongly associated with what disease?
Myasthenia gravis
What antibodies are formed in myasthenia gravis?
Antibodies targeting post-synaptic acetylcholine nicotinic receptors
How does one diagnose myasthenia gravis?
Tensilon (Edrophonium) test
What is Edrophonium?
AChE inhibitor
What cancer is strongly associated with Lambert-Eaton syndrome?
Small cell carcinoma of the lung
What antibodies are produced in Lambert-Eaton syndrome?
Antibodies directed against voltage-gated calcium channels
Weakness during the early part of the day that improves with greater activity is seen in what NMJ disease?
Lambert-Eaton syndrome
Antibodies to acetylcholine nicotinic receptors at the NMJ causes what disease?
Myasthenia gravis
What is the fick equation?
Cariac output = oxygen consumption divided by (arterial O2 content - venous O2 content)
What artery is at risk in a supracondylar fracture of the femur?
Popliteal artery
What artery is at risk in a posterior dislocation of the knee?
Popliteal artery
The popliteal is from what artery?
Superficial femoral artery
What arteries does the popliteal artery give rise to distal to the knee?
Anterior tibial a. And posterior tibial artery
What artery gives rise to the dorsalis pedis artery?
Anterior tibial artery
What artery gives rise to the the pulse posterior to the medial malleolus?
Posterior tibial artery
What does the posterior tibial artery divide into to supply the plantar region of the foot?
Medial and lateral plantar arteries
What artery supplies the posterior compartment of the thigh?
Profunda femoris artery
Coagulative necrosis of a tumor is due to what?
Ischemia - not enough vascular supply to keep up with the rapid neoplastic growth
Name 5 neutrophil chemoattractants
C5a, IL-8, leukotriene B4, fibrinopeptides, formyl methionyl peptides
What is the equation for specificity?
True negatives/(true negatives + false positives)
What is the equation for sensitivity?
TP/(TP+FN)
What affect does phenobarbital have on the CYP450 system?
Induces it
What organelle is the CYP450 found in?
Smooth endoplasmic reticulum of hepatocytes
What are the best markers for identification of B cells?
CD19, CD20, CD21
What cells are CD28+?
T cells
What cells are CD56+?
NK cells
Osteogenesis imperfecta results from a defect in what?
Type I collagen - hydroxylation of proline and lysines