Random Mix #1 Flashcards
Causes of unconjugated/indirect hyperbilirubinemia
Hemolytic
Physiologic
Crigler-Najjar Syndrome (=UDP-glucuronyl transferase defcy)
Gilbert Syndrome (= glucuronyltransferase mutn)
Causes of conjugated/direct hyperbilirubinemia
Biliary tract obstruction Biliary tract disease (primary sclerosing cholangitis, primary biliary cirrhosis) Dubin-Johnson Syndrome (=cMOAT defcy) Rotor Syndrome (=low bilirubin transport)
Causes of mixed hyperbilirubinemia
Hepatitis
Cirrhosis
Trousseau Syndrome
Association of migratory thrombophlebitis with pancreatic cancer (or other adenocarcinoma//lung/colon/gastric)
–Seen with weight loss and abdominal pain
Dieterle Silver Stain is used to identify…
Legionella pneumophila
Quellung reaction is used to identify…
the capsular serotype of strep. pneumo.
Four genera that have a requirement of cysteine
Francisella, Brucella, Pasteurella, Legionella
Most common causes of Carpal Tunnel Syndrome
Myxoedema Edema Diabetes mellitus Idiopathic Acromegaly Neoplasm
Trauma
Rheumatoid arthritis
Amyloidosis
Pregnancy
Boundaries of the anatomical snuffbox
Abductor pollicis longus
Extensor pollicis longus
Extensor indicis
(all innervated by Radial nerve)
Radial nerve is characteristically injured during what type of fracture? and/or during what type of compression?
Mid-humeral shaft fracture
and/or
extended axillary compression of spiral groove
Most common immunodeficiency in the U.S.
Selective IgA deficiency
South American malaria is resistant to…
chloroquine
Chloroquine can exacerbate the symptoms of…
psoriasis.
Can also cause “chloroquine retinopathy”
Treatment of choice for unknown species of Plasmodium falciparum that is chloroquine-resistant (or patient is unable to tolerate chloroquine)
Atovaquone + Proguanil
Combination therapy for Cryptococcus neoformans
Amphotericin B + Flucystocine
Therapy for cytomegalovirus infections
Gancyclovir
Combination therapy for life-threatening bacterial infections, i.e. pseudomonal infections
Gentamycin + Ceftriaxone
Uses of Foscarnet (phosphonoformic acid)
Against CMV infections with immunocompromised patients
Mechanism of Foscarnet
Inhibits viral DNA polymerase by mimicking pyrophosphate portions of nucleotide triphosphates
Mechanism of Tetracycline
Inhibits aminoacyl-tRNA to ribosomes
Mechanism of fluoroquinolones
Inhibit DNA gyrase and topoisomerase IV
Blocks release of ACh
Causes flaccid paralysis via neurotoxin
Clostridium botulinum
Blocks release of GABA and Glycine
Causes spastic paralysis via neurotoxin
Clostridium tetani
Increase levels of cAMP
Enterotoxigenic
E. coli (ETEC)
Vibrio cholerae
Bordatella pertussis
Bacillus anthracis
Most common urea cycle disorder
Ornithine transcarbamylase (OTC) deficiency
Ornithine transcarbamylase deficiency inheritance and symptomology
X-lined recessive Lethargic neonate Poorly controlled breathing/body temp Unusual body movements Hyperammonemia Elevated glutamine Elevated urine orotic acid
Most distinctive glomerular lesion associated with diabetes
Nodular glomerulosclerosis (Kimmelstiel-Wilson nodule)
Characterized by:
Proteinuria/nephrotic syndrome
Nodular/ovoid hyaline masses
Thickened basement membranes
A palpable mass in the left supraclavicular node can be the presenting finding of…
gastric carcinoma
Most common causes of drug-induced lupus
Procainamide (sodium channel blocker)
Hydralazine (adjunct HTN therapy)
Isoniazid (TB med)
Prototypical CREST Syndrome presentation
Calcinosis/anti-Centromere antibodies Raynaud's phenomenon Esophagela dysmotility Sclerodactyly Telangiectasias of the skin
Carcinomas spread via…
lymphatics into regional lymph nodes.
Sarcomas and carcinomas that typically metastasize via hematogenous spread
Renal cell carcinoma
Hepatocellular carcinoma
Follicular carcinoma of thyroid
Choriocarcinoma (malignancy of trophoblasts)
Carcinoma that characteristically seeds body cavities
Ovarian carcinoma
esp. to peritoneum
Von Willebrand factor is derived from…
Weibel-Palade bodies of endothelial cells and alpha-granules of platelets
Test that measures extrinsic and common pathways of coagulation cascade
Prothrombin Time
F7; 2, 5, 10, and fibrinogen
Test that measures the intrinsic and common pathways of the coagulation cascade
Partial Thromboplastin Time
F12, 11, 9, 8; 2, 5, 10, and fibrinogen
Treatment for disorders of fibrinolysis due to plasmin overactivity
Aminocaproic Acid
blocks activation of plasminogen
What are lines of Zahn?
Alternating layers of platelets/fibrin and RBCs seen with thrombosis
What is the Virchow Triad?
1) disruption of blood flow
2) endothelial cell damage
3) hypercoaguable state
Presentation of Cystathionine beta-Synthase (CBS) Deficiency
Homocystinuria Vessel thrombosis Mental retardation Lens dislocation Long slender fingers
Hookworms responsible for iron deficiency anemia in the developing world
Ancylostoma duodenale
Necator americanus
Presentation of Plummer-Vinson Syndrome
Anemia (microcytic, iron def anemia)
Dysphagia (esophageal web)
Beefy-Red Tongue (atrophic glossitis)
What is the rate limiting step in the production of heme?
Succinyl CoA ======> ALA (aminolevulinic acid)
Enzyme: [ALA synthase]
Cofactor: Vit B6
What is the final step in the production of heme and where does it occur?
Iron binds to Protoporphyrin via [Ferrochelatase] in the mitochondria
What other condition has similar iron laboratory findings as Microcytic Sideroblastic Anemia?
Hemachromatosis
both “iron overloaded state”
What are the three normal types of hemoglobin?
alpha2 gamma2 = HbF
alpha2 beta2 = HbA
alpha2 delta2 = HbA1
What is hemoglobin Barts?
Tetramer of gamma-globin chains seen with alpha-thalassemia (four gene deletions)
*incompatible with life => hydrops fetalis
What is HbH?
Tetramer of beta-globin chains seen with alpha-thalassemia (three gene deletions)
=> severe anemia
What virus can lead to an aplastic crisis with beta-Thalassemia Major or Hereditary Spherocytosis patients?
Parvovirus B19
Where is folate absorbed from food?
Jejunum
