RHS2 Flashcards
high concentrations of what drugs cause cardiac arrhythmias and seizures
Theophylline
oropharyngeal candidiasis
short or long term adverse effect
inhaled corticosteroids is short term effect,
long term can stunt growth, osteoporosis, cataracts(comparatively the systemic long term effects are cushings)
Rare side effects include reversible dermatitis, myositis, or gastroenteritis, pulmonary infiltration with eosinophilia and anaphylaxis.
cromylin and nedocromylin release inhibitors of mast cells
Used in the management of NSAID- exacerbated respiratory disease (NERD)
Leukotriene-Modifying Agents
adverse effects of the Leukotriene-Modifying Agents
zlieuten = hepatotoxicty
the Lukasts=neuropsychiatric events: agitation, aggressive behavior, anxiety, depression, hallucinations, insomnia, somnambulism, suicidal thoughts and behavior (including suicide).
may produce anaphylactic reactions
Omalizumab
Breaks disulfide linkages in mucus and lowers viscosity
N-Acetylcysteine (mucolytic agent used for COPD)
what antibiotics are used for COPD pts to reduce exaccerbations
Long-term azithromycin and erythromycin reduces exacerbations.
most effective single-agent maintenance therapy for allergic rhinitis.
Glucocorticoid nasal sprays -used when allergic rhinitis is effecting quality of life
antihistamine not benefitial for congestions, more for itching ad sneezing (second gen H1x = Cetrizine, Fexofenadine, Loratadine)
-Nosebleed
-Nasal septal perforation
-Nasopharyngeal candidiasis
Glucocorticoid nasal spray
Suppress cough reflex via a direct action on the
cough center in the medulla of the brain.
AE?
Codeine and Dextromethorphan(better)
AE: constipation and drowsy
those agents that kill sexual stages and prevent transmission to mosquitoes (malaria)
gametocyte(the infective form that is aquired by the vector in a blood meal from host
-primaquine
queries with chloroquine
-dont give iV bc causes hypotension and cardiac arrest
-avoid in G6PD, psoriasis, and porphyria
-causes visual problems
what AE is different of hydroxychloroquine from chloroquine
Pruritus
-does not have the hypotension nd cardiac arrest problem
Blackwater fever
hemolysis from quinidine
quinidine AE
pancytopenia, uterine contractions, Cinchonism, hemolysis
doxycycline ae
Photosensitivity
Teeth discoloration
Growth stunting
Pseudomembranous colitis
Clindamycin
mefloquine ae
-who should avoid this drug
Neuropsychiatric: dizziness, loss of balance, ringing in the ears, anxiety, depression, hallucinations
Avoided in patients with epilepsy, psychiatric disorders,cardiac arrhythmias
last resort tx for severe malaria
mefloquine
Disrupts mitochondrial electron transport
Atovaquone
Tetracycline antibiotic: protein synthesis inhibitor by binding to 30s ribosome of plasmodium ribosome
doxycycline
Protein synthesis inhibitor binds to the 50S ribosome subunit in susceptible
microorganisms and blocks translocation
clindamycin
Binds to iron, breaking down peroxide bridges leading to generation of free radicals that damage parasite protein
Artemisinin
Prevents hemoglobin breakdown due to buildup of free heme
chloroquine
Intercalates into DNA, disrupting parasite’s replication and transcription
quinidine
binds to 𝜷 subunit of bacterial DNA-dependent RNA polymerase leading to inhibition of RNA synthesis
rifampin
point mutations in rpoB
rifampin
-Reduced binding to RNA polymerase
strong CYP P450 inducer
rifampin
opposite of rifabutin
what kind of orgs for rafampin (what is it used for)
-Gram + and -
SMALL P
-serious staph, MRSA, Active TB, Latent Tb, Leprosy, prophylaxis for meningitis and Hib
Synthetic analog of pyridoxine
will compete with vit B6
isoniazid
inhibits synthesis of mycolic acids, leading to disruption of cell wall
isoniazid and ethionamide
KatG
catalase peroxidase
gives isoniazid high level of resistance with mutation
inhA
NADH-dependent acyl carrier protein reductase gives isoniazid low level of resistance from overexpression
Kasa
β keto-acyl carrier protein synthetase
-give isoniazid low level resistance
CYP P450 inhibitor
isoniazid
Metabolized by the liver N-acetyltransferase
isonioazid
-can present with lupus like sx
-dangerous for slow acetylators
isoniazid ae
Lupus like sx
GI
Hemolysis with G6PD
hepatotoxicity
neurotoxicity!
what to give ofr isoniazid neurotoxcity-peripheral neuropathy, restlessness, muscle twitching, seizures, memory loss & insomnia seen in slow acetylators
pyroxidine - vitB6
isoniazid causes B6 def which causes sideroblastic anemia(lab findings will be similar to hemochromotosis
Relative of nicotinamide
pyrazinamide
pyrazinamide AE
polyarthralgia, hyperuricemia(not for gout pts), hepatotoxicity
inhibits arabinosyltransferases
ethambutol
emb gene
ISHIHARA test
red green eye test for ethambutol
inhibits protein synthesis by binding at 30s mycobacterial ribosome
streptomycin and amikacin
when to use streptomycin
life threatening TB:
- TB meningitis
- miliary (if military doesnt involve the CNS, bones, joints, give standard)
- severe organ TB
STREPTOMYCIN AE
ototoxicity(vertigo, hearing loss)
hepatotoxicity
nephrotoxicity
-same AE for amikacin
ethionamide AE
gastric irritation, neurotoxicity (can be alleviated by pyridoxine supplementation)
and hepatotoxicity
interferes with DNA replication by inhibiting DNA gyrase (topoisomerase II)
LEVOFLOXACIN(Fluoroquinolone), anthracyclins, etoposide
tendinopathy
LEVOFLOXACIN
dihydropteroate synthase inhibition
dapson
will inhibit folate synthesis
used in the treatment of pneumonia caused by Pneumocystis jirovecii in HIV-AIDS
patients
dapson
dapson AE
hemolysis in G6PD
methemoglobinemia
Erythema nodosum leprosu
Erythema nodosum leprosum treated with
Thalidomide
primary resistance vs acquired resistance
priamry= no response with first exposure
acquired=single drug resisitance, multi drug resistance(one exposure makes you resistant to a whole bunch of drugs the next time-efflux pump-P. glycopreotinc
common effects of chemotherapy
vomitting, stomatitis, bone marrow suppression, alopecia
sx of tumor lysis syndome
what is the management?
when treating leukemia/ lymphomas
-Hyperuricemia
* Hyperkalemia
*Hyperphosphatemia
* Hypocalcemia
* Uric acid and calcium phosphate crystals > renal failure.
Meg: saline, allopurinol or rasbiuricase
chemo drugs that commonly have AE myelosupression
A C DVD
Alkylating agent, Cytrabine, Doxorubicin, VinBLASTIN, Daunorubicin
Inhibits dihydrofolate reductase
-causes what to decrease
methotrexate
The synthesis of dTMP and purine nucleotides decrease therefore Adenine and Guanine
chemo drugs that frequently have the AE emetogenic
cisplatin, carmustine, cyclophosphamide, Mechloretamine, Dacarbazine
what does methotrexate covert to by what enzyme
polyglutamates via folylpolyglutamate synthase
-strongly charged-ion trapping
methotrexate adverse effects
Commons
Renal Damage
Liver Damage
Pneumonitis
Neurologic Toxic
*mouth soars , relieve with leucovin
Dohl bodies
Seen in reactive neutrophillia in sepsis pts. Indicated leukemoid rxn!
Genetic abnormalities with aml
whichhave good and poor prognosis?
15,17 trans. 16,16. 8,21 have good prognosis
11 translocation or deletion of chrom 5 is poor prognosis
Pml-RARA
T15,17 acute promyelocytic leukemia M3.causes DIC
Downs syndrome
Acute megakaryoblastic leukemia m7
Flow cytometry AML
CD 33, 34, 15
MDS»_space;
AML
-will have hypercellular B but very low counts in serum, still less than 20%
Ringed sideriblasts
Iron laden macrophages. Stains prussian blue
MDS
PseudoPelger Huet
Neutrophils with only two lobes
MDS
Megakayocyree eill have multi nuclei
CML MUTATION
T9,22
BCR-ABL
Causes uncontrolled prolif if neoplastic granulocytes
JAK 2 pt mutationa
Polycythemia vera, essential thrombocutosis, primary myelofibrosis
Myeloproliferstive neosplasm»_space;
Acute leukemia
NAP (neutrophil alkaline phosphatase)
Score is high for leukemoid rxn and low for CML
Imatinib
Tyrosine kinase inhibitor of fusion BCR-ABL1/ 9-22 (CML)
Neoplastic megakaryocytes secrete PDGF AND TGFB
Primary myelofibrosis
Bud chiari syndrome
whats dz
Hepatic artery thrombosis in plycythemia vera and essentual thrombocytosis and PNH
Aquagenic pruritis
Itch after the water in polycythemia vera
Waldeyer ring
Non hodgkins lymphoma
in oropharynx
How does hodgkins lymphoma spread through the body
Node to node to spleen to liver to bone marrow
Myeloperoxidase negative
Sudan black B negative
Periodic acid Schiff stain is positive
Myeloperoxidase negative (marker of granulocytes)
* Sudan black B negative (no fats; so, no lysosomes
Periodic acid Schiff stain is positive (due to the presence of glycogen inclusions)
ALL
flow cytometry for ALL
tdt, CD 10, 19, 22
mutations with ALL and prognosis
t12,21 = good
t9,22 = bad
ball? tall has inc mediastinum and htlv-1 infection
CLL vs SLL
CLL = absolute lymphocyte count more than 5000
SmallLymphocyticLymphoma presents the same but will have less lymphocyte count
CLL/SLL mutation
delete 13q and overexpress BCL2
CD5
CLL
and CD 20
CLL»_space;
progressive pancytopenia
DLBCL (Richter transformation)
BRAF mutations
hairy cell leukemia
beefy spleen
hairy cell leukemia
red pulp infultation
fried egg bone marrow biopsy
hairy cell leukemia
tartrate-resistant acid phosphatase (TRAP)
hairy cell leukemia
flow cytometry for hairy cell leukemia
CD 11c, 103, Annexin A1
mutation in follicular lymphoma
number, gene names, gene function
t 14,18
IGH-BCL2
**overexpression of antiapoptotic
follicular lymphoma»_space;
DLBCL (ritchie transformation)
DLBCL mutation
BCL6 and BCL2
MALToma
extranodal lymphoma
often marginal zone lymphoma
what conditions can cause marginal zone lymphona/ maltoma
salivary gland in Sjögren disease, the thyroid gland in Hashimoto thyroiditis, and the stomach in Helicobacter pylori gastritis.
t11, 18 mutaion
burkitt mutation
t8 14
C-MYC
starry sky
burkitt lymphoma,
multiple myeloma mutation
translocations involving IgG locus on chromosome 14 to cyclin D1 and cyclin D3 oncogenes.
will produce M protien(bence jones)
will present with hypercalcemia and dec EPO
Rouleaux, Russle bodies
multiple myeloma
plasma cells more than 30% of the cells
multiple myeloma
hodgkins lymphoma mutation
mutations involving loss of β2-microglobulin function and tumor cells
fail to express MHC I molecules
express high levels of PD-1 (programmed death) ligands that help evade immune surveillance.
hodgkins lymphoma RS cells
classical vs non classical hodgkins lymphoma and what CD markers
classical: nodular sclerosis, mixed cellularity, T rich, T depleted. CD15, 30 positive, CD45 negative
varient is CD 45 positive and CD 15 and 30 negative
nodular sclerosis with lacunar cells- hodgkins lymphoma
associated with what lymph nodes
Mediastinal lymph nodes
excellent prognosis
EBV associated with
mixed cellularity hodgkins lymophoma, lymphocyte rich HL, and lymphocyte depleted HL(unfavorable prognosis), burkitt lymphoma, infectious mononucleolus
varient Hodgkind Lymohoma effects which lymph nodes
cervical and axillary lymphadenopathy.
“popcorn” cell. puffy
Lymphohistiocytic variant RS in varient HL
analog of hypoxanthine is converted to in what pathways
6-MERCAPTOPURINE is converted to thio-IMP (TIMP) via HGPRT
what metabolize 6 MP
metabolized to thiouric acid by xanthine oxidase and thiopurine methyltransferase (TPMT)[both 6MP and 6TG are metabolized by TPMT]
what dose needs to be decreased with 6MP
allopurinol
6MP needs to be metabolized by XO which is blocked by allopurinol
not needed with 6thioguanine
6 thioguanine converted to what by what enzyme
Converted to the nucleotide 6-thioGMP (TGMP) by HGPRT.
Converted to the deoxyribonucleotide 5-FdUMP and what is this proteins purpose
5 flourouricil
5-FdUMP inhibits thymidylate synthase: DNA synthesis is inhibited=thymine less!
accumulation of dump
enzyme that metabolizes of 5FU
5-FU is mainly metabolized by the enzyme dihydropyrimidine dehydrogenase (DPD).
chemotherapy for colorectal cancer
5-FU/leucovorin (leucovorin will potentiate, strengthen the 5FU)
5FU AE
usual + erythematous desquamation of the palms and soles called the “hand-foot syndrome”
The incorporated residue
inhibits DNA polymerase.
CYTARABINE
what causes cardio toxcitiy with anthracyclins
ROS production
-tx with dexrazoxane
4 MOAs of anthracyclins
inhibit topo 2
block synth of DNA and RNA with strand breaks
binding to cell membranes and alters fluidity
produce ROS
unique AE of antracyclins
cardiotoxciity
Arrest cells in G2 phase
bleomycin
Powerful vesicant
leads to tissue necrosis
mechlorethamine
Activated by CYP2B
cyclophosphamide
unique AE of cyclophosphamide(when protein is responsible and what is the antidote)
hemorrhaagic cyctitis
-Acreolin is what is responsible
-antidote is Mesna(also use mesna with ifosfamide)
unique AE of Ifosfamide
Greater platelet suppression, neurotoxicity[hallucinations, coma]**, and urinary tract toxicity,hemoragic cystitis
Useful in treatment of brain tumours
nitrosoureas
can cross the BBB
unique AE of procarbazine
-weak MAO inhibitor(no tyramine containing foodS)
-disulfram like reaction to alcohol
Inhibit DNA synthesis and bind DNA through formation of cross-links
cisplatin and carboplatain (platimun CC)
unique AE of cisplatin and any anditofe
ototoxcitiy, peripheral neuropathy, nephrotoxcitiy(antidote is amifostine)
bind to β-tubulin and inhibit its ability to polymerize into microtubules
destabalizing VINCA alkyloids
β-tubulin subunit of microtubules and promote microtubule polymerization
stabalizing taxanes
also leads to apoptosis
Unique AE for pacilitaxine
antidote?
peripheral neuropathy (not as much as VINCRISTIN)
Hypersensitivity(antidote for this is H2 blockers, dextamethazone, diphenhydramine
Inhibit topoisomerase I
camptothecins
unique AE of camptothecins
diahreah
antiagonist to breat tissue and agonist for non breast tissue
tamoxifen
what to avoid with tamoxifen
CYP2D6 inhibintors = fluoxitine, paroxitine, bupropion
uses for tamoxifen
metastatic breast cancer
breast cancer prophylaxis
adjunctant therapy
adverse effects of tamoxifen -5
hot flashes, fluid retention,vaginal bleeding, venous thrombosis, inc incidence of endometrial cancer
antiestrogen in breat and uterus and proestrogen in bone
raloxifen
uses of raloxifen
osteoperosis, breast cancer prophylaxis in post menopausal women
AE of raloxifen
hot flashes, leg cramps, thromboembolism
similar to tamoxifen but no uterine sx
what are the steroidal and nonsteroidal aromatoase inhibitors
what is reversible and irreversible
anastrozole and letrozole and non steroidal and reversible competitive
exemestane is steroidal are irreversible inhibitor
what drug is also given with GnRH releasing agonist
flutamide- eventually there will be a dec in testosterone and estrogen but at first there will be a surge and causing a flare up of the cancer
what is GnRH releasing agonists used for -3
- advanced carcinoma of prostate
- advanced breast cancer in premenopausal women
- management of endometriosis
Irreversible inhibitor of CYP17A1.
ABIRATERONE
causes dec in testosterone production
Abiraterone AE
what is an antidote
CYP17A1 inhibition causes adrenocortical insufficiency, hypertension, hypokalemia and fluid retention.
-antidote: prednisone
can also cause hepatotoxicity and cardiac arythmias
Asparaginase AE
CNS!!!
HS
potential ammonia toxicity causing pancreatitis, siezures,
INC ammonia!
Inhibits ribonucleotide reductase
what is this used for
hydroxyurea
-kills cells in the S phase
treatment for SCD
bacteria catalase positive, oxidase negative, non-lactose fermenting
other catalase positive fungus
oxidase positive bacteria
yersinia
asperigillus
legionella
three types of yersinia
Y. enterocolitica -enteric
Y. pseudotuberculosis -septisemic-gangrene
Y. pestis - bio warfare, bubonic plauge-boild
resoviour for yersinia and transmission vectors
rodents, flea
can effect human via contact with rodents or infected fleas vectors
Y pestis virulence factors and function -6
Pla protein and Murine toxin will activate plasminogen and destroy C3d and C5a
V antigens controlls secretions
F1 envelope antigen forms an antiphagocytic capsule (look for this in serology!)
Yersininbactin and LPS cuase bacteremia
what are the three types of bartonella and what dz are they associated with
gram?
➢B. henselae (Cat scratch disease)
➢B. quintana (Trench fever)
➢B. bacilliformis (Carrion’s disease)
gram -
transmission vectors and resiovors for bartonell
B. henselae vector = flea and resiouvor = cat
B. quintana vector = louse. resiouvour not mentioned
B bacilliformis vecotr = sand fly. resiovuor not mentioned
Bacillary angiomatosis
assocaited with B hensalae and B quintana
cranberry like lesions when immunocompromised are infected. looks like kaposi sarcoma
Bacillary peliosis caused by B.hensalae is
associated with vascular lesions in the liver
and spleen.
carrions dx stages
Acute = oroya fever(malase, painless liver, spleen, and lymph enlargement, hemolytic anemia
chronic or erruptive= verruga peruana
what orgs cause viral hemorrhagic fever
Bunyaviridae(hanta)
Flaviviridiae
Arenavirdiae
Filoviridae(Marburg, Ebola)
- ss RNA viruse
can be used as bio warefare
will lose homeostasis of man organ systems and bleeding from everywhere
3 types of filariasis and what do they infect on humans
lymphatic, hydrocele -Wuchereria Bancofti
Subcutaneous -Lao lao, onchocera
serous cavity -Mansonella
filariasis transmitted by
black fly and mosqioto
transmits the L3 larvae
-woms in lymphatics and microfilariasis in blood
The parasite interferes with lymphatic function and causes damaging inflammation in the organs they inhabit
filariasis
elephantitis
Babesiosis vector and resiovour
tick vector, definitive host
resiovour in rodents and farm animals
Inside the rodent, sporozoites infect erythrocytes and reproduce asexually forming trophozoites and merozoites. the merozoites go into the blood of the tick and then sporocytes will fomr
ring trophosite
elliptical “pear-shaped” forms sometimes seen as tetrads (“Maltese cross”) within _______
B. microti merozoites
babesioses
within RBC
plasmodium life cycle and vectors
infect erythrocytes (RBC’s) of vertebrate host, asexual repoduction.
sexual reproduction in mosquito (definitive host). transmitted by Anophele mosquito
mosquito injects sporotozites -> mature to schizonts and burst as merozoites ot can remain dorment in liver cells as hyponozoites(P. ovale and P vivax) and will go to erythrocyte as merozoitoes
“ring forms”
featured in RBC when with malaria its the early trophozites. Malaria falc will have multiple
what mutations give malaria resistance
SCD, alpha and beta thasalemia, G6PD, hemolytic anemia, duffy antigen mutation
fungal pathogens that are predomently east or west coast USA
east coast =histoplasma and blastomyces, babiosis
south west, dry season = coccidiodies, hantavirus, yersinia
histoplasma source and site in the body
sx?
source is the droppings of birds, soil
reside in intracellular macrophages with oval bodies inside. can cause pneumonia or granulomas, erythemia nordosa, hepatosplenomegaly
blastocmyctes source
what will it do
sx?
soil, nitrogen rich, decaying wood, leaves
it will change its structure based on it enviornmnet
pathcy hazy infultrate with possible cavities and can disseminate to effect skin and bones
which fungal infection makes granulomatous infalmmation with giant cells
coccidiodies make SPHERULES inside the lung as SPORE/ Arthroconidia!
how does Paracoccidioides clinically present
ulcerated lesions in the nose/mouth and lung, hepatosplenomegaly. cervical lymphadenopathy. granulomas in the lungs
translucent cell walls and multi bud
in CSF. clear halo around yeast.
-source
-what is infected with what virulence factors
Cryptococcus
has a THICK polysacc capsule (encapsulated yeast) upon inhalation(antiphagocytic),
found in SOIL with bird poop.
common in HIV/ low T CD4/ sarcoidosis.
melanin produced to avoid immune system
Pneumocystis key words
3 stage life cycle
white plaques,
wall made of cholesterol not egosterol
HIV
AIDS
inhalation of arthrocondia
what happens after inhallation
cocciodiodies
after inhalation enlarges to a barrel sized spherule/ endospore that will protect itself from phagocytosis
what are the oppertunistic fungal infections
Cryptococcus neoformans
Pneumocytsis jirvecii
Aspergillus
multimorphic fungi
will see both hyphae and condia inside the body.
Aspergillus
atypical features of atypical pneumonia from Legionella
may have purulent/bloody mucoid sputum
confusion**
GI symptoms**
elevated hepatic enxymes
kidney function dec like hematuria and hyponatremia
-look for water exposure and gradual onset
agars, stains, and diagnostic test for legionella
buffered charcoal yeast extract (BCYE) agar
methylamine silver stain
urinary antigen Lp1 diagnostic
what syndromes from from legionella
Pontiac fever
Legionnaire’s disease(pneumonia)
legionella virulence factors
growth intracellularly of macrophages
can prevent the fusion of phagosome-lysosome
describe structure of Chlamydiaceae org
Outer cell wall resembles G –ve, weakly endotoxic LPS, lacks peptidoglycan
Major Outer Membrane Protein (MOMP) in the cell wall
produce spore like Elementary bodies(the resistant form) which can transfer to reticulate body which is metabolically active. The EB will prevent fusion of cytoplasmic phagosome that it is in with the lysosome
Chlamydia psittaci resoviour and effect on the human host
birds, NOT the droppings
liver and kidney necrosis, seeded in the lungs and causes alveoli lymphocytosis. can cause mucus plugs and edema from all the inflammatory markers in the lungs
strong CNS** and GI** involvement, hepatomegalt and splenomegaly
Hantavirus family name and most common dz
Family – Bunyaviridae
Sin Nombre virus(SNV
hantavirus resivior
rodents
no person to person transmission
what season associated with hantavirus
fall
- Generalized increase in capillary permeability that results from endothelial damage
- Injury is a consequence of the host’s immunological response to viral antigens that have penetrated the endothelium
hanta virus
clinical stages of the hanta virus
- prodromal- common flu sx
- cardiopulmunary- dry cough, edema, circulatory collapse
- convalescent- diuresis
-Burkholderia pseudomallei dz and sx
Melioidosis, Whitmore’s disease
osteomyelitis, encephalomyelitis, organ abscesses, parotitis, sepsis
water loving
Legionella
Burkholderia pseudomallei
both G-
what respiratory organism has particular suseptibility to cystic fibrosis
Burkholderia pseudomallei
Burkholderia pseudomallei agar and agar presentation
Ashdown’s agar
cornflower head appearence
Q fever,
complications
Coxiella burnetii
presents with pneumonia and hepatitis.
complications:culture negativ eendocarditis, osteomyelitis suseptible in those with cardiac damage, pregnant, and immunocompromised
Hematopoietic growth factors -5
Erythropoietin (JAK/STAT r)
Darbepoetin (longer half life)
Filgrastim (G-CSF stimulates neutrophils. AE. bone pain)
Sargramostim (GM-CSF stimulates all myeloid lineages)
Interleukin-11(megakaryocyte stimulation)
Iron chelators
Deferoxamine - IV
Deferasirox - oral
needed in beta thalassemia major
drugs that inhibit B12 absorbtion-6
metformin,
protonpumpinhibitors,
histamine2receptor antagonists(cimetidine,ranitidine, famotidine, nizatidine), neomycin,
nitrous oxide
anesthesia
ha mnn no p
anti-platelet antibodies
chronic immune thrombocytopenia purpura
destruction of IgG coated platelets
Ribavirin
antiviral recommended for severe RSV
hypersegmented neutrophil
hyposegmented neutrophil
Hypersegmented: Megaloblastic anemia 5+ lobes
Hypo segmented: MDS (Pseudo Pelger Huet cells, 2 lobes)
monotonous lymphocyte with high mitoses and apotosis
burkitt lymphoma
Mutation in B2 microglobbulin where the tumor cells fail to express MHC 1
reed steelburg cell. hodgkins
calls will also have a high level of PD1 to evade the immune system
schilling test
B12 def
Henoch-Schönlein purpura
hypersensitivity vasculitis- damages the vessel wall due to the
deposition of immune complexes.
child has triad: purpura(palpable), arthritis, abdominal pain
normocellular marrow with increased numbers of megakaryocytes, some of which are slightly immature in appearance
chronic immune thrombocytopenia purapura (antiplatelet antibodies against GpIIb/IIIa- effects platlet AGGREGGATION(like Glazzman) and GpIb/IX - platelet ADHESION(like bernard s))
-differenitate from DIC bc here there will be Hx of bleeding not from a specific incidence
decongestants oral and nasal
oral: phenylepherine, pseudoepherine
nasal: phenylepherine, oxymetholazine (do not use nasal more than 3 days in a row bc causes robound conjestion, can replace with intranasal CS)
activate a1 adrenic receptors to constrict
safety pin, bi polar
yersinia, Burkholderia pseudomallei
both are gram -
Retro-orbital pain, fever, back pain, skin rash
bartonella
methotreate antidote
Leucovorin
rescues bone marroe and helps with mouth soars
Coxiella burnetii resoviour
what dz?
cattle, sheep, goats, tick
Q fever(flu, pneumonia, hepitits)
ebola
family and category
vectors
where does microbe live in human
filovirus. -ssRNA
vectors: fruit bats, chimps, monkeys, deer(bush meat), human spread as well
lives in macrophages
unique bi phasic life cycle
what dz
Chlamydia psittaci
Ornithosis (Psittacosis or Parrot fever)
inactive EB and active RB
myobacteirum TB goes into the______ (first responce- innate and adaptive)
go through TB infection process
macrophage and dendrtitic cells as the innate responce
in the T cells as the adaptive responce
will try to clear, if not will become latent(gohn focus, complex near hilar). will reactive if AIDS, eledery. reactivated bc there is a drop in CD4T cells and will allow bacteria to travel to the oxygen rich apex. will from cavitations and necosis(can creep to the vascular system and then will become disseminated TB)
active will have sx
