Random Facts Flashcards
Artery Derivatives of 1st Pharyngeal (Branchial) Arch
Maxillary Artery (branch of external carotid)
Artery Derivatives of 6th Pharyngeal (Brachial) Arch
- Proximal Part of Pulmonary Artery
2. Ductus Aretriosus (on the left side only)
Artery Derivatives of 3rd Pharyngeal (Brachial) Arch
- Internal Carotid (proximal part)
2. Common Carotid Artery
Artery Derivatives of 4th Pharyngeal (Brachial) Arch
- Aortic Arch
2. Right Subclavian Artery
Artery Derivatives of 2nd Pharyngeal (Brachial) Arch
- Stapedial Artery
2. Hyoid Artery
Artery Derivatives of 5th Pharyngeal (Branchial) Arch
There is NO 5th arch in post natal life!!!
It disapppears prenatally
Germ Layer sources for Pharyngeal (Brachial) Arch
Mesoderm (muscle and arteries)
Neural Crest Cells
Germ Layer sources for Pharyngeal (Branchial) Cleft
Ectoderm
Germ Layer sources for Pharyngeal (Branchial) Pouch
Endoderm
Branchial Cleft Derivatives
1: external auditory meatus
2-4: temporary cervical sinuses—->then obliterated by proliferation of 2nd arch mesenchyme
Nerve Supply of 3rd Pharyngeal (Branchial) Arch
CN 9
Nerve Supply of 4th Pharyngeal (Branchial) Arch
CN 10 (superior laryngeal branch)
Nerve Supply of 2nd Pharyngeal (Brachial) Arch
CN 7
Nerve Supply of 6th Pharyngeal (Branchial) Arch
CN 10 (recurrent laryngeal nerve)
Nerve Supply of 1st Pharyngeal (Branchial) Arch
CN V2 and CNV3
Cartilage of 3rd Pharyngeal (Branchial) Arch
Greater horn of hyoid
Cartilage of 4th Pharyngeal (Brachial) Arch
thyroid cricoid arytenoids corniculate cuneiform
Cartilage of 2nd Pharyngeal (Branchial) Arch
Reichert’s Cartilage:
- stapes
- styloid process
- lesser horn of hyoid
- stylohyoid ligament
Cartilage of 1st Pharyngeal (Branchial) Arch
Merkel’s Cartilage:
- mandible
- malleus
- incus
- spheno-mandibular ligament
Cartilage of 6th Pharyngeal (Branchial) Arch
thyroid cricoid arytenoids corniculate cuneiform
Muscle derivatives of 6th Pharyngeal (Branchial) Arch
All intrinsic muscles of the larynx, EXCEPT cricothyroid
Muscle derivatives of 4th Pharyngeal (Branchial) Arc
- Most pharyngeal constrictors
- cricothyroid
- levator veli palatini
Muscle derivatives of 1st Pharyngeal (Branchial) Arc
Muscles of Mastication:
- temporalis
- masetter
- lateral and medial pterygoids
- mylohyoid
- anterior belly of digastric
- tensor tympani
- tensor veli palatini
Muscle derivatives of 3rd Pharyngeal (Branchial) Arc
StyloPHARYNGEUS (innervated by glossoPHARYNGEAL nerve )
Muscle derivatives of 2nd Pharyngeal (Branchial) Arc
Muscles of Facial Expression:
- stapedius
- stylohyoid
- posterior belly of digastric
Abnormalities of 1st Pharyngeal Arch
Treacher-Collins Syndrome
Abnormalities of 3rd Pharyngeal Arch
Congenital Pharyngeocutaneous fistula
Derivatives of 3rd Branchial (PHARYNGEAL) pouch
Dorsal Wings: inferior parathyroids
Ventral Wings: Thymus
Derivatives of 2nd Branchial (PHARYNGEAL) pouch
Epithelial Lining of palantine tonsil
Derivatives of 4th Branchial (PHARYNGEAL) pouch
Dorsal WIngs: superior parathyroids
Derivatives of 1st Branchial (PHARYNGEAL) pouch
- middle ear
- eustachian tube
- mastoid air cells
Causes of Di George Syndrome?
- abberant dvt, of 3rd and 4th pouches…leading to
a) T-cell deficiency (thymic aplasia)
b) Hypocalcemia (failure of parathyroid development)
Characteristics of Childhood Brain Tumors: Pilocytic Astrocytoma:
Rosenthal Fibers(eosinophilic, corkscrew fibers). Also cystic and solid on gross inspection.
Characteristics of Childhood Brain Tumors: Medulloblastoma:
Homer-Wright Rosettes which look like small blue cells on histology. Also radio sensitive
Characteristics of Childhood Brain Tumors: Epyndioma:
Perivascular rosettes. Rod-Shaped blepharoplasts(basal ciliary bodies) found near nucleus
Characteristics of Childhood Brain Tumors: Hemangioblastoma
Foamy Cells and high vascularity.
Characteristics of Childhood Brain Tumors: Caniopharyngioma
Tooth-enamel-like calcification
Alzheimer’s Proteins and the corresponding chromosome numbers? Distinguish between early onset and late onset Alzheimer’s.
EARLY ONSET:
Amyeloid Precursor Protein—XSome #21
Presenilin-1—–XSome # 14
Presenilin-2—–XSome #1
LATE ONSET:
APOE4—-XSome #19
NB: APOE2 on XSome #19 is PROTECTIVE!!!!
Characteristics of Neurocutaneous Disorders?
Sturge-Weber Syndrome
- Congenital disorder with port-wine stains [Nevus Flammeus] typically in V1 opthalmic distribution
- ipsilateral leptomeningeal angiomas
- pheocyochromocytoma
- Can cause: a) Glaucoma
b) Seizures
c) Hemiparesis/Hemiplegia
d) Mental Retardation
GENETICS: This occurs sporadically…no genetic component
Characteristics of Neurocutaneous Disorders?
Tuberous Sclerosis
MNEMONIC = H.A.M.A.R.T.O.M.A.S
1)Hamartomas in Skin and CNS
2) Adenoma Sebaceum (cutaneous angiofibromas)
3) Mitral Regugitation
4) Ash-leaf spots
5) cardiac Rhabdomyoma
6) Tuberous Sclerosis
7) Mental Retardation
8) renal Angiomyolipoma
9) Seizures
GENETICS: Autosomal Dominant
Characteristics of Neurocutaneous Disorders?
Neurofibromaosis type I (von Recklinghausen’s Disease)
1) Cafe-au-lait spots
2) Lisch Nodules (pigmented iris haramatoms)
3) neurofibromas in skin
4) optic gliomas
5) pheocytochromocytoma
GENETICS: Autosomal Dominant mutation in NF1 gene on Xsome #17—–100% penetrance, variable expression
Characteristics of Neurocutaneous Disorders?
von Hippel-Landau disease
Cavernous Hamangioms in
1) skin
2) mucosa
3) organs
4) bilateral renal cell carcinoma
5) hemangioblastoma in a) retina
b) brain stem
c) cerebellum
6) pheocytochromocytoma
GENETICS: Autosomal Dominant mutation in tumor suppressor VHL gene on XSome # 3
***ofetn produces EPO—>Polycythemia
Demyelinating and Dysmyelinating Diseases:
PML
- cause?
- structure damaged?
Caused by JC virus
-common in patients with HIV as part of secondary/latent infection
- destruction of oligodendrocytes. leading to demyelination of CNS
- progressive and fatal
Demyelinating and Dysmyelinating Diseases:
ACUTE DISSEMINATED (postinfectious) ENCEPHALOMYELITIS
- cause?
- structure damaged?
- Caused by measles or VZV or certain vaccinations (rabies and smallpox)
- multifocal perivenular inflammation and demyelination that occurs AFTER INFECTION
Demyelinating and Dysmyelinating Diseases:
METACHROMATIC LEUKODYSTROPHY
- cause?
- structure damaged?
- Lysosomal storage disease (autosomal recessive)
- Caused by deficiency in ARYL SULAFTASE A
-Lack of enzyme leads to accumulation of sulfatides and therefore, decreased production of myelin
Demyelinating and Dysmyelinating Diseases:
CHARCOT-MARIE-TOOTH DISEASE
- cause?
- structure damaged?
- caused by defective producton of proteins required in the structure+function of peripheral nerves and myelin
- kids described as clumsy, damaged to deep peroneal nerve===>legs look like inverted bottle and they have abnormal proproception and vibratory sense
Demyelinating and Dysmyelinating Diseases:
KRABBE’s DISEASE
- cause?
- structure damaged?
- Lysosomal storage disease (autosomal recessive)
- Caused by deficiency in GALACTOCEREBROSIDASE
-buildup of galactocerebroside destroys myelin sheath
Most common causes of meningitis in Imunocompromised patients?
Cryptococcus Neoformans (forms monoformic yeast)…this is much more common than
Aspergillus (which forms septate hyphae)
Diarrhea, wheeing, flushing, right-sided valvular disease, liver lesions and appendix lesions =?
How do you treat this condition?
CARCINOID SYNDROME!!!
—Treat with ocreotide, which inhibits hormone release and hormone-like substances
Hormone which stimulates pancreatic duct bicarbonate secretion?
Where is this hormone produced?
Any other functions of the hormone?
SECRETIN produced by duodenal S-cells
also stimulates bile secretion and inhibits gastric acid secretion
Hormone which stimulates exocrine pancrease enzyme secretion?
Where is this hormone produced?
Any other functions of the hormone?
CHOLECYSTOKININ produced by duodenal I-cells
- stimulates gall bladder contraction
- inhibits gastric emptiying
- increases sphincter of Oddi relaxation
Treatment of Wilson’s Disease?
-NAME 2
==penicillamine (antidote)
==Tri-entine
Giemsa staining organisms
Chlamydia, Borrelia, Rickettsia, Trypanosomes,Plasmodium
Which organisms grown on the following special cultures?
CHOCOLATE AGAR with Factor V and X:
THAYER-MARTIN or VPN MEDIA:
BORDET-GENGOU (potato) AGAR:
CHOCOLATE AGAR with Factor V and X:
hemophilus B
THAYER-MARTIN or VPN MEDIA:
Neisseria-both
BORDET-GENGOU (potato) AGAR:
bordetella pertussi
Which organisms grown on the following special cultures?
TELLURITE AGAR, LOFFLER MEDIUM:
LOWENSTEIN-JENSEN AGAR:
EATON AGAR:
TELLURITE AGAR, LOFFLER MEDIUM:
C. diptheriae
LOWENSTEIN-JENSEN AGAR:
mycobacterium
EATON AGAR:
mycoplasma
Which organisms grown on the following special cultures?
MacCONKEY AGAR:
CHARCOAL YEAT EXTRACT (buffered with cysteine and iron):
SABORAUD AGAR:
MacCONKEY AGAR:
-lactose fermenting enterics
CHARCOAL YEAST EXTRACT (buffered with cysteine and iron):
-legionella
SABORAUD AGAR:
-fungi
This is the only Gram Positive bacteria with a polypeptide capsule formed by D-glutamate
Bacillus Anthracis
- -Cause:
1) cutaneous anthrax –black eschar
2) pulmonary anthrax (wool sorter’s disease)
Which bacteria form spores?
NB: autoclave at 121 deg for 15min to kill spores
Clostrodium and Bacillus (Cereus and Antracis)
At their core, spores contain DIPI-COLINIC acid. And spores are NOT metabolically active
What is Cereulide?
Preformed toxin from B.Cereus
-Causes reheated rice syndrome
This bacteria can cause spontaneous abortion and self-limited gastroenteritis
Listeria Monocytogenes!!
Facultative anaerobe hence causes granulomatosis infanticemia.
-the only GP bacterium that produces LPS
(hence causes septicemia and amnionitis.
But major diseases are 1) neonatal meningitis and 2) meningitis in immunocompromised
This filamented bacteria causes oral/facial abscesses that drain through sinus tracts?
Actinomyces
Yellow “sulfur granules” in abscesses
What is the treatment?
Actinomyces
rx= penicillin
Where is Nocadia found?
-Which 2 diseases does it cause?
Transmission is exogenous (FROM SOIL!)
Causes:
1) pulm infections in immunocompromised
2) cutaneous infections after trauma in immunoCOMPETENT.
Rx= sulfonamides
If this bacteria is left for a long time, it forms a molar tooth shape.
What is the treatment?
Actinomyces
Rx= Penicillin
Treatment for tuberculoid hansen disease versus. lepramatous hansen disease?
tuberculoid LEPROSY:
- dapsone
- rifampine
lepramatous LEPROSY:
- dapsone (also given to family members since leprosy is contagious)
- rifampine
- clofa-zimine
This bacteria grows purple/black colonies with a green sheen on EMB agar.
E.Coli.
Otherwise= pink on MaConkey due to lactose fermentation via B-galactosidase
This bacteria causes mucoid colonies due to abundant polysaccharide capsules.
Klebsiella!!
Hence the currant-jelly sputum
Rose-spots on the abdomen, Fever, headache and diarrhea?
Salmonella Typhi-induced “ENTERIC FEVER”
Latency established in gall bladder
Triple Therapy for H.Pylori?
- PPI
- Clarithromycin
- Metronidazole or Amoxicillin
Therapy for Pseudomonas?
1) Aminoglycoside +
2) Pip-Tazo (extended spectrum penicilin e.g. Piperacillin, Ticarcilin) or CEFEPIME (A 4th gen cephalosporin)
Treatment for Syphillis?
Penicillin G
Treatment for Lyme Disease
Doxycycline, Ceftriaxone
VDRL gives false positves in?
-name 5
- SLE
- Viral e.g. EBV and Hepatitis
- some Drugs
- Rheumatic Fever
- Leprosy
This bacteria which cannot be seen on gram stain and cannot be cultured, lackes MURAMIC ACID in it’s cell wall.
Chlamydia!
Visible by cytoplasmic inclusions on Giemsa or fluorescent antibody.
This hematologic protozoa causes malaria-like symptoms[headache, anemia, splenomegaly, fever] and HEMOLYTIC ANEMIA?
what is the treatment?
Babesia which causes babesiosis
Rx= is different from Lyme Disease (doxy); we use Atovaquone and Azithromycin
Treatment for Toxoplasma Gondii?
Sulfadiazine and Pyrimethamine
Treatment for life-threatening malaria?
IV Quinidine if life threathening
For ovale/vivax===add primaquine (afer testing for G6PD) to chloroquine
If resistant, use mefloquine or Atovaquine/Proguanil
Treatment for Chagas disease?
Benznidazole or Nifurtimox
Treatment for Visceral Leishmaniasis
Amphotericin B or Sodium Stibogluconate
Treatment for Vaginitis due to Trichomonas Vaginalis?
Metronidazole
This parasite shows amastigotes in macrophages?
Visceral Leishmaniasis caused by Leishmania Donovani
These two organisms enter via the cribriform plate?
- Naegleria Fowleri [protozoa penetrating the CNS]
- Mucor and Rhiopus [fungi in leukemic patients and ketotic diabetics]
DNA viruses that are not linear?
- Papilloma
- Polyoma
- Hepadnavirus (circular)
+ ssRNA viruses?
-Retrovirus
-Picoma
-Calici
-Toga
-Flavi
-Corona
Hepevirus (causes HEV)
Which worm or parasite causes Biliary tract disease and cholangiocarcinoma?
Clonorchis Sinensis (a liver fluke)…obtained from undercooked fish.
Rx= praziquantel
Which worm or parasite causes portal hypertension?
Schistosoma Mansoni and
Schistosoma Japonia
both of which are flukes
Rx= praziquantel
Most enveloped viruses aquire their envelope from the host cell membrane, except for one group?
Which one and where does it get it’s evelope from?
herpesviruses get their coats from the nuclear membrane
Name 2 recombinant viral vaccines?
- HBV (made from HBV surface antigen)
- HPV (6, 11, 16, and 18)
What is the Tanck test used for?
Detection of HSV.
Amino acids used in purine synthesis?
Glycine
Arginine
Glutamine
=”G.A.G”
In prokaryotes, which DNA polymerase enzymes have 3’ –> 5’ exonuclease and which one has 5’ –> 3’ exonuclease activity?
DNA Pol III (main one)=====3’ –> 5
DNA Pol I (for lagging strand)==== 5’ –> 3’
Where does mRNA quality control happen in the cytoplasm?
on P-bodies [contain exonucleases, decapping enzymes, and miRNA]
anti-U1 RNP (splicing molecules) antibodies are expressed in which disease?
Mixed connnective tissue disease
anti-snRNPs antibodies are expressed in which disease?
anti-snRNPs= anti-Smith :)))
SLE (highly specific)
Cre-Lox system?
Inducibly manipulating genes at specific time developmental points, e.g. to study a gene whose deletion causes embryonic death.
Mode of inheritance of the following two diseases:
–Hereditary Spherocytocis
–Ornithine Transcarbamylase
–Hereditary Spherocytocis= A.DOMINANT
–Ornithine Transcarbamylase = X-linked Recessive
Myonecrosis and an increase in CPK and Aldolase are seen in which condition?
–Which lab tests confirm the diagnosis?
DMD!!! (frameshift—->in BMD= point mutation)
Confirm with Western Blot and Muscle biopsy
DMPK gene mutation and CTG trinucleotide repeat?
-which disease
Mytotonic Dystophy Type I
muscle atrophy, hypotonia, testicular atrophy, arrythmia, cataracts, frontal balding
X-linked disease with a mutation in the FMR1 gene?
Fragile X Syndrome
4 diseases with trinucleotide repeats and may exhibit anticipation?
huntington= CAG
friedreich’s= GAA
fragile x = CGG
Mytotonic Dystrophy = CTG
Defects in 3rd and 4th brachial pouches?
CATCH-22 deletion syndromes (Di George and Velocardiofacial Syndrome)
C=cardiac defects A=abnormal facies T=thymic aplasia C=cleft palate H=hyPOcalcemia
Which 2 amino acids are purely ketogenic?
Leucine and Lysine
Factors that activate PDH
exercise which increases
1) Ca2+
2) NAD+
3) ADP
This inherited metabolic disorder can lead to E.Coli sepsis in neonates?
Classic Galactosemia
Treatment for hyperamonia?
- Lactulose (traps ammonium)
- benzoate (bind a-acids and lead to excretion)
- phenylbutyrate (bind a-acids and lead to excretion)
Treatment of Vanc Resistant Enterococci?
Streptogramins (quinupristin and dalfopristin)
Linezolid
Treatment of MRSA?
- Daptomycin [depolarizes the cell membrane]
- Ceftaroline [5the gen cephalosporin]
- Vancomycin [binds D-ala-D-ala units]
- Linezolid [causes serotonin syndrome]
- Tigecycline
Antimicrobial drugs to avoid in pregrancy?
–Name 9
- Tetracyclines (discolored teeth and poor growth)
- Aminoglycosides (Ototoxicity)
- Fluoroquinolone (cartilage/bone/tendon damage)
- Chloramphenicol (gray baby syndrome)
- sulfonamides (kernicterus)
- clarithromycin (embryotoxic)
- Griseofulvin (teratogenic)
- Ribavirin (severe teratogenicity)
- Delavirdine and Efavirenz ()
Decreased orexin in the lateral hypothalamus
Narcolepsy!!
Treatment for Trigeminal Neuralgia?
Carbamazepine
Treatment for Cluster Headache?
inhaled oxygen or SUMATRIPTAN
