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term 4 > RHS2 > Flashcards

RHS2 Flashcards

1
Q

high concentrations of what drugs cause cardiac arrhythmias and seizures

A

Theophylline

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2
Q

oropharyngeal candidiasis

short or long term adverse effect

A

inhaled corticosteroids is short term effect,
long term can stunt growth, osteoporosis, cataracts(comparatively the systemic long term effects are cushings)

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3
Q

Rare side effects include reversible dermatitis, myositis, or gastroenteritis, pulmonary infiltration with eosinophilia and anaphylaxis.

A

cromylin and nedocromylin release inhibitors of mast cells

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4
Q

Used in the management of NSAID- exacerbated respiratory disease (NERD)

A

Leukotriene-Modifying Agents

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5
Q

adverse effects of the Leukotriene-Modifying Agents

A

zlieuten = hepatotoxicty

the Lukasts=neuropsychiatric events: agitation, aggressive behavior, anxiety, depression, hallucinations, insomnia, somnambulism, suicidal thoughts and behavior (including suicide).

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6
Q

may produce anaphylactic reactions

A

Omalizumab

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7
Q

Breaks disulfide linkages in mucus and lowers viscosity

A

N-Acetylcysteine (mucolytic agent used for COPD)

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7
Q

what antibiotics are used for COPD pts to reduce exaccerbations

A

Long-term azithromycin and erythromycin reduces exacerbations.

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8
Q

most effective single-agent maintenance therapy for allergic rhinitis.

A

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)

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9
Q

-Nosebleed
-Nasal septal perforation
-Nasopharyngeal candidiasis

A

Glucocorticoid nasal spray

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10
Q

Suppress cough reflex via a direct action on the
cough center in the medulla of the brain.
AE?

A

Codeine and Dextromethorphan(better)

AE: constipation and drowsy

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11
Q

those agents that kill sexual stages and prevent transmission to mosquitoes (malaria)

A

gametocyte(the infective form that is aquired by the vector in a blood meal from host
-primaquine

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12
Q

queries with chloroquine

A

-dont give iV bc causes hypotension and cardiac arrest

-avoid in G6PD, psoriasis, and porphyria
-causes visual problems

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13
Q

what AE is different of hydroxychloroquine from chloroquine

A

Pruritus
-does not have the hypotension nd cardiac arrest problem

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14
Q

Blackwater fever

A

hemolysis from quinidine

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15
Q

quinidine AE

A

pancytopenia, uterine contractions, Cinchonism, hemolysis

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16
Q

doxycycline ae

A

Photosensitivity
Teeth discoloration
Growth stunting

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17
Q

Pseudomembranous colitis

A

Clindamycin

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18
Q

mefloquine ae
-who should avoid this drug

A

Neuropsychiatric: dizziness, loss of balance, ringing in the ears, anxiety, depression, hallucinations
Avoided in patients with epilepsy, psychiatric disorders,cardiac arrhythmias

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19
Q

last resort tx for severe malaria

A

mefloquine

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20
Q

Disrupts mitochondrial electron transport

A

Atovaquone

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21
Q

Tetracycline antibiotic: protein synthesis inhibitor by binding to 30s ribosome of plasmodium ribosome

A

doxycycline

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22
Q

Protein synthesis inhibitor binds to the 50S ribosome subunit in susceptible
microorganisms and blocks translocation

A

clindamycin

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23
Q

Binds to iron, breaking down peroxide bridges leading to generation of free radicals that damage parasite protein

A

Artemisinin

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24
Q

Prevents hemoglobin breakdown due to buildup of free heme

A

chloroquine

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25
Q

Intercalates into DNA, disrupting parasite’s replication and transcription

A

quinidine

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26
Q

binds to 𝜷 subunit of bacterial DNA-dependent RNA polymerase leading to inhibition of RNA synthesis

A

rifampin

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27
Q

point mutations in rpoB

A

rifampin
-Reduced binding to RNA polymerase

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28
Q

strong CYP P450 inducer

A

rifampin
opposite of rifabutin

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29
Q

what kind of orgs for rafampin (what is it used for)

A

-Gram + and -

SMALL P
-serious staph, MRSA, Active TB, Latent Tb, Leprosy, prophylaxis for meningitis and Hib

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30
Q

Synthetic analog of pyridoxine

A

will compete with vit B6
isoniazid

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31
Q

inhibits synthesis of mycolic acids, leading to disruption of cell wall

A

isoniazid and ethionamide

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32
Q

KatG

A

catalase peroxidase
gives isoniazid high level of resistance with mutation

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33
Q

inhA

A

NADH-dependent acyl carrier protein reductase gives isoniazid low level of resistance from overexpression

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34
Q

Kasa

A

β keto-acyl carrier protein synthetase
-give isoniazid low level resistance

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35
Q

CYP P450 inhibitor

A

isoniazid

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36
Q

Metabolized by the liver N-acetyltransferase

A

isonioazid
-can present with lupus like sx
-dangerous for slow acetylators

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37
Q

isoniazid ae

A

Lupus like sx
GI
Hemolysis with G6PD
hepatotoxicity
neurotoxicity!

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38
Q

what to give ofr isoniazid neurotoxcity-peripheral neuropathy, restlessness, muscle twitching, seizures, memory loss & insomnia seen in slow acetylators

A

pyroxidine - vitB6

isoniazid causes B6 def which causes sideroblastic anemia(lab findings will be similar to hemochromotosis

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39
Q

Relative of nicotinamide

A

pyrazinamide

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40
Q

pyrazinamide AE

A

polyarthralgia, hyperuricemia(not for gout pts), hepatotoxicity

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41
Q

inhibits arabinosyltransferases

A

ethambutol
emb gene

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42
Q

ISHIHARA test

A

red green eye test for ethambutol

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43
Q

inhibits protein synthesis by binding at 30s mycobacterial ribosome

A

streptomycin and amikacin

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44
Q

when to use streptomycin

A

life threatening TB:
- TB meningitis
- miliary (if military doesnt involve the CNS, bones, joints, give standard)
- severe organ TB

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45
Q

STREPTOMYCIN AE

A

ototoxicity(vertigo, hearing loss)
hepatotoxicity
nephrotoxicity

-same AE for amikacin

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46
Q

ethionamide AE

A

gastric irritation, neurotoxicity (can be alleviated by pyridoxine supplementation)
and hepatotoxicity

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47
Q

interferes with DNA replication by inhibiting DNA gyrase (topoisomerase II)

A

LEVOFLOXACIN(Fluoroquinolone), anthracyclins, etoposide

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48
Q

tendinopathy

A

LEVOFLOXACIN

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49
Q

dihydropteroate synthase inhibition

A

dapson
will inhibit folate synthesis

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50
Q

used in the treatment of pneumonia caused by Pneumocystis jirovecii in HIV-AIDS
patients

A

dapson

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51
Q

dapson AE

A

hemolysis in G6PD
methemoglobinemia
Erythema nodosum leprosu

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52
Q

Erythema nodosum leprosum treated with

A

Thalidomide

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53
Q

primary resistance vs acquired resistance

A

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

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54
Q

common effects of chemotherapy

A

vomitting, stomatitis, bone marrow suppression, alopecia

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55
Q

sx of tumor lysis syndome
what is the management?

A

when treating leukemia/ lymphomas
-Hyperuricemia
* Hyperkalemia
*Hyperphosphatemia
* Hypocalcemia
* Uric acid and calcium phosphate crystals > renal failure.
Meg: saline, allopurinol or rasbiuricase

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56
Q

chemo drugs that commonly have AE myelosupression

A

A C DVD
Alkylating agent, Cytrabine, Doxorubicin, VinBLASTIN, Daunorubicin

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57
Q

Inhibits dihydrofolate reductase
-causes what to decrease

A

methotrexate

The synthesis of dTMP and purine nucleotides decrease therefore Adenine and Guanine

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57
Q

chemo drugs that frequently have the AE emetogenic

A

cisplatin, carmustine, cyclophosphamide, Mechloretamine, Dacarbazine

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57
Q

what does methotrexate covert to by what enzyme

A

polyglutamates via folylpolyglutamate synthase

-strongly charged-ion trapping

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58
Q

methotrexate adverse effects

A

Commons
Renal Damage
Liver Damage
Pneumonitis
Neurologic Toxic

*mouth soars , relieve with leucovin

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59
Q

Dohl bodies

A

Seen in reactive neutrophillia in sepsis pts. Indicated leukemoid rxn!

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60
Q

Genetic abnormalities with aml
whichhave good and poor prognosis?

A

15,17 trans. 16,16. 8,21 have good prognosis

11 translocation or deletion of chrom 5 is poor prognosis

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61
Q

Pml-RARA

A

T15,17 acute promyelocytic leukemia M3.causes DIC

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62
Q

Downs syndrome

A

Acute megakaryoblastic leukemia m7

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63
Q

Flow cytometry AML

A

CD 33, 34, 15

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64
Q

MDS&raquo_space;

A

AML
-will have hypercellular B but very low counts in serum, still less than 20%

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65
Q

Ringed sideriblasts

A

Iron laden macrophages. Stains prussian blue

MDS

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66
Q

PseudoPelger Huet

A

Neutrophils with only two lobes
MDS

Megakayocyree eill have multi nuclei

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67
Q

CML MUTATION

A

T9,22
BCR-ABL
Causes uncontrolled prolif if neoplastic granulocytes

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68
Q

JAK 2 pt mutationa

A

Polycythemia vera, essential thrombocutosis, primary myelofibrosis

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69
Q

Myeloproliferstive neosplasm&raquo_space;

A

Acute leukemia

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70
Q

NAP (neutrophil alkaline phosphatase)

A

Score is high for leukemoid rxn and low for CML

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71
Q

Imatinib

A

Tyrosine kinase inhibitor of fusion BCR-ABL1/ 9-22 (CML)

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72
Q

Neoplastic megakaryocytes secrete PDGF AND TGFB

A

Primary myelofibrosis

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73
Q

Bud chiari syndrome
whats dz

A

Hepatic artery thrombosis in plycythemia vera and essentual thrombocytosis and PNH

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74
Q

Aquagenic pruritis

A

Itch after the water in polycythemia vera

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75
Q

Waldeyer ring

A

Non hodgkins lymphoma
in oropharynx

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76
Q

How does hodgkins lymphoma spread through the body

A

Node to node to spleen to liver to bone marrow

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77
Q

Myeloperoxidase negative
Sudan black B negative
Periodic acid Schiff stain is positive

A

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

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78
Q

flow cytometry for ALL

A

tdt, CD 10, 19, 22

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79
Q

mutations with ALL and prognosis

A

t12,21 = good
t9,22 = bad

ball? tall has inc mediastinum and htlv-1 infection

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80
Q

CLL vs SLL

A

CLL = absolute lymphocyte count more than 5000
SmallLymphocyticLymphoma presents the same but will have less lymphocyte count

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81
Q

CLL/SLL mutation

A

delete 13q and overexpress BCL2

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82
Q

CD5

A

CLL
and CD 20

83
Q

CLL&raquo_space;

A

progressive pancytopenia
DLBCL (Richter transformation)

84
Q

BRAF mutations

A

hairy cell leukemia

85
Q

beefy spleen

A

hairy cell leukemia
red pulp infultation

86
Q

fried egg bone marrow biopsy

A

hairy cell leukemia

87
Q

tartrate-resistant acid phosphatase (TRAP)

A

hairy cell leukemia

88
Q

flow cytometry for hairy cell leukemia

A

CD 11c, 103, Annexin A1

89
Q

mutation in follicular lymphoma
number, gene names, gene function

A

t 14,18
IGH-BCL2
**overexpression of antiapoptotic

90
Q

follicular lymphoma&raquo_space;

A

DLBCL (ritchie transformation)

91
Q

DLBCL mutation

A

BCL6 and BCL2

92
Q

MALToma

A

extranodal lymphoma
often marginal zone lymphoma

93
Q

what conditions can cause marginal zone lymphona/ maltoma

A

salivary gland in Sjögren disease, the thyroid gland in Hashimoto thyroiditis, and the stomach in Helicobacter pylori gastritis.

t11, 18 mutaion

94
Q

burkitt mutation

A

t8 14
C-MYC

95
Q

starry sky

A

burkitt lymphoma,

96
Q

multiple myeloma mutation

A

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

97
Q

Rouleaux, Russle bodies

A

multiple myeloma

98
Q

plasma cells more than 30% of the cells

A

multiple myeloma

99
Q

hodgkins lymphoma mutation

A

mutations involving loss of β2-microglobulin function and tumor cells
fail to express MHC I molecules

100
Q

express high levels of PD-1 (programmed death) ligands that help evade immune surveillance.

A

hodgkins lymphoma RS cells

101
Q

classical vs non classical hodgkins lymphoma and what CD markers

A

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

102
Q

nodular sclerosis with lacunar cells- hodgkins lymphoma
associated with what lymph nodes

A

Mediastinal lymph nodes
excellent prognosis

103
Q

EBV associated with

A

mixed cellularity hodgkins lymophoma, lymphocyte rich HL, and lymphocyte depleted HL(unfavorable prognosis), burkitt lymphoma, infectious mononucleolus

104
Q

varient Hodgkind Lymohoma effects which lymph nodes

A

cervical and axillary lymphadenopathy.

105
Q

“popcorn” cell. puffy

A

Lymphohistiocytic variant RS in varient HL

106
Q

analog of hypoxanthine is converted to in what pathways

A

6-MERCAPTOPURINE is converted to thio-IMP (TIMP) via HGPRT

107
Q

what metabolize 6 MP

A

metabolized to thiouric acid by xanthine oxidase and thiopurine methyltransferase (TPMT)[both 6MP and 6TG are metabolized by TPMT]

108
Q

what dose needs to be decreased with 6MP

A

allopurinol
6MP needs to be metabolized by XO which is blocked by allopurinol

not needed with 6thioguanine

109
Q

6 thioguanine converted to what by what enzyme

A

Converted to the nucleotide 6-thioGMP (TGMP) by HGPRT.

110
Q

Converted to the deoxyribonucleotide 5-FdUMP and what is this proteins purpose

A

5 flourouricil
5-FdUMP inhibits thymidylate synthase: DNA synthesis is inhibited=thymine less!
accumulation of dump

111
Q

enzyme that metabolizes of 5FU

A

5-FU is mainly metabolized by the enzyme dihydropyrimidine dehydrogenase (DPD).

112
Q

chemotherapy for colorectal cancer

A

5-FU/leucovorin (leucovorin will potentiate, strengthen the 5FU)

113
Q

5FU AE

A

usual + erythematous desquamation of the palms and soles called the “hand-foot syndrome”

114
Q

The incorporated residue
inhibits DNA polymerase.

A

CYTARABINE

115
Q

what causes cardio toxcitiy with anthracyclins

A

ROS production
-tx with dexrazoxane

116
Q

4 MOAs of anthracyclins

A

inhibit topo 2
block synth of DNA and RNA with strand breaks
binding to cell membranes and alters fluidity
produce ROS

117
Q

unique AE of antracyclins

A

cardiotoxciity

118
Q

Arrest cells in G2 phase

A

bleomycin

119
Q

Powerful vesicant

A

leads to tissue necrosis
mechlorethamine

120
Q

Activated by CYP2B

A

cyclophosphamide

121
Q

unique AE of cyclophosphamide(when protein is responsible and what is the antidote)

A

hemorrhaagic cyctitis
-Acreolin is what is responsible
-antidote is Mesna(also use mesna with ifosfamide)

122
Q

unique AE of Ifosfamide

A

Greater platelet suppression, neurotoxicity[hallucinations, coma]**, and urinary tract toxicity,hemoragic cystitis

123
Q

Useful in treatment of brain tumours

A

nitrosoureas
can cross the BBB

124
Q

unique AE of procarbazine

A

-weak MAO inhibitor(no tyramine containing foodS)
-disulfram like reaction to alcohol

125
Q

Inhibit DNA synthesis and bind DNA through formation of cross-links

A

cisplatin and carboplatain (platimun CC)

126
Q

unique AE of cisplatin and any anditofe

A

ototoxcitiy, peripheral neuropathy, nephrotoxcitiy(antidote is amifostine)

127
Q

bind to β-tubulin and inhibit its ability to polymerize into microtubules

A

destabalizing VINCA alkyloids

128
Q

β-tubulin subunit of microtubules and promote microtubule polymerization

A

stabalizing taxanes
also leads to apoptosis

129
Q

Unique AE for pacilitaxine
antidote?

A

peripheral neuropathy (not as much as VINCRISTIN)
Hypersensitivity(antidote for this is H2 blockers, dextamethazone, diphenhydramine

130
Q

Inhibit topoisomerase I

A

camptothecins

131
Q

unique AE of camptothecins

A

diahreah

132
Q

antiagonist to breat tissue and agonist for non breast tissue

A

tamoxifen

133
Q

what to avoid with tamoxifen

A

CYP2D6 inhibintors = fluoxitine, paroxitine, bupropion

134
Q

uses for tamoxifen

A

metastatic breast cancer
breast cancer prophylaxis
adjunctant therapy

135
Q

adverse effects of tamoxifen -5

A

hot flashes, fluid retention,vaginal bleeding, venous thrombosis, inc incidence of endometrial cancer

136
Q

antiestrogen in breat and uterus and proestrogen in bone

A

raloxifen

137
Q

uses of raloxifen

A

osteoperosis, breast cancer prophylaxis in post menopausal women

138
Q

AE of raloxifen

A

hot flashes, leg cramps, thromboembolism

similar to tamoxifen but no uterine sx

139
Q

what are the steroidal and nonsteroidal aromatoase inhibitors
what is reversible and irreversible

A

anastrozole and letrozole and non steroidal and reversible competitive

exemestane is steroidal are irreversible inhibitor

140
Q

what drug is also given with GnRH releasing agonist

A

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

141
Q

what is GnRH releasing agonists used for -3

A
  1. advanced carcinoma of prostate
  2. advanced breast cancer in premenopausal women
  3. management of endometriosis
142
Q

Irreversible inhibitor of CYP17A1.

A

ABIRATERONE
causes dec in testosterone production

143
Q

Abiraterone AE
what is an antidote

A

CYP17A1 inhibition causes adrenocortical insufficiency, hypertension, hypokalemia and fluid retention.
-antidote: prednisone

can also cause hepatotoxicity and cardiac arythmias

144
Q

Asparaginase AE

A

CNS!!!
HS
potential ammonia toxicity causing pancreatitis, siezures,

INC ammonia!

145
Q

Inhibits ribonucleotide reductase
what is this used for

A

hydroxyurea
-kills cells in the S phase
treatment for SCD

146
Q

bacteria catalase positive, oxidase negative, non-lactose fermenting

other catalase positive fungus

oxidase positive bacteria

A

yersinia

asperigillus

legionella

147
Q

three types of yersinia

A

Y. enterocolitica -enteric
Y. pseudotuberculosis -septisemic-gangrene
Y. pestis - bio warfare, bubonic plauge-boild

148
Q

resoviour for yersinia and transmission vectors

A

rodents, flea

can effect human via contact with rodents or infected fleas vectors

149
Q

Y pestis virulence factors and function -6

A

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

150
Q

what are the three types of bartonella and what dz are they associated with

gram?

A

➢B. henselae (Cat scratch disease)
➢B. quintana (Trench fever)
➢B. bacilliformis (Carrion’s disease)

gram -

151
Q

transmission vectors and resiovors for bartonell

A

B. henselae vector = flea and resiouvor = cat

B. quintana vector = louse. resiouvour not mentioned

B bacilliformis vecotr = sand fly. resiovuor not mentioned

152
Q

Bacillary angiomatosis

A

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.

153
Q

carrions dx stages

A

Acute = oroya fever(malase, painless liver, spleen, and lymph enlargement, hemolytic anemia

chronic or erruptive= verruga peruana

154
Q

what orgs cause viral hemorrhagic fever

A

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
155
Q

3 types of filariasis and what do they infect on humans

A

lymphatic, hydrocele -Wuchereria Bancofti
Subcutaneous -Lao lao, onchocera
serous cavity -Mansonella

156
Q

filariasis transmitted by

A

black fly and mosqioto
transmits the L3 larvae

-woms in lymphatics and microfilariasis in blood

157
Q

The parasite interferes with lymphatic function and causes damaging inflammation in the organs they inhabit

A

filariasis

elephantitis

158
Q

Babesiosis vector and resiovour

A

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

159
Q

elliptical “pear-shaped” forms sometimes seen as tetrads (“Maltese cross”) within _______

A

B. microti merozoites

babesioses

within RBC

160
Q

plasmodium life cycle and vectors

A

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

161
Q

“ring forms”

A

featured in RBC when with malaria its the early trophozites. Malaria falc will have multiple

162
Q

what mutations give malaria resistance

A

SCD, alpha and beta thasalemia, G6PD, hemolytic anemia, duffy antigen mutation

163
Q

fungal pathogens that are predomently east or west coast USA

A

east coast =histoplasma and blastomyces, babiosis

south west, dry season = coccidiodies, hantavirus, yersinia

164
Q

histoplasma source and site in the body

sx?

A

source is the droppings of birds, soil

reside in intracellular macrophages with oval bodies inside. can cause pneumonia or granulomas, erythemia nordosa, hepatosplenomegaly

165
Q

blastocmyctes source
what will it do

sx?

A

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

166
Q

which fungal infection makes granulomatous infalmmation with giant cells

A

coccidiodies make SPHERULES inside the lung as SPORE/ Arthroconidia!

167
Q

how does Paracoccidioides clinically present

A

ulcerated lesions in the nose/mouth and lung, hepatosplenomegaly. cervical lymphadenopathy. granulomas in the lungs

translucent cell walls and multi bud

168
Q

in CSF. clear halo around yeast.

-source
-what is infected with what virulence factors

A

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

169
Q

Pneumocystis key words

A

3 stage life cycle
white plaques,
wall made of cholesterol not egosterol
HIV
AIDS

170
Q

inhalation of arthrocondia

what happens after inhallation

A

cocciodiodies

after inhalation enlarges to a barrel sized spherule/ endospore that will protect itself from phagocytosis

171
Q

what are the oppertunistic fungal infections

A

Cryptococcus neoformans
Pneumocytsis jirvecii
Aspergillus

multimorphic fungi

172
Q

will see both hyphae and condia inside the body.

A

Aspergillus

173
Q

atypical features of atypical pneumonia from Legionella

A

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

174
Q

agars, stains, and diagnostic test for legionella

A

buffered charcoal yeast extract (BCYE) agar
methylamine silver stain
urinary antigen Lp1 diagnostic

175
Q

what syndromes from from legionella

A

Pontiac fever
Legionnaire’s disease(pneumonia)

176
Q

legionella virulence factors

A

growth intracellularly of macrophages

can prevent the fusion of phagosome-lysosome

177
Q

describe structure of Chlamydiaceae org

A

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

178
Q

Chlamydia psittaci resoviour and effect on the human host

A

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

179
Q

Hantavirus family name and most common dz

A

Family – Bunyaviridae

Sin Nombre virus(SNV

180
Q

hantavirus resivior

A

rodents
no person to person transmission

181
Q

what season associated with hantavirus

A

fall

182
Q
  • 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
A

hanta virus

183
Q

clinical stages of the hanta virus

A
  1. prodromal- common flu sx
  2. cardiopulmunary- dry cough, edema, circulatory collapse
  3. convalescent- diuresis
184
Q

-Burkholderia pseudomallei dz and sx

A

Melioidosis, Whitmore’s disease

osteomyelitis, encephalomyelitis, organ abscesses, parotitis, sepsis

185
Q

water loving

A

Legionella
Burkholderia pseudomallei

both G-

186
Q

what respiratory organism has particular suseptibility to cystic fibrosis

A

Burkholderia pseudomallei

187
Q

Burkholderia pseudomallei agar and agar presentation

A

Ashdown’s agar
cornflower head appearence

188
Q

Q fever,
complications

A

Coxiella burnetii

presents with pneumonia and hepatitis.
complications:culture negativ eendocarditis, osteomyelitis suseptible in those with cardiac damage, pregnant, and immunocompromised

189
Q

Hematopoietic growth factors -5

A

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)

190
Q

Iron chelators

A

Deferoxamine - IV
Deferasirox - oral

needed in beta thalassemia major

191
Q

drugs that inhibit B12 absorbtion-6

A

metformin,
protonpumpinhibitors,
histamine2receptor antagonists(cimetidine,ranitidine, famotidine, nizatidine), neomycin,
nitrous oxide
anesthesia

ha mnn no p

192
Q

anti-platelet antibodies

A

chronic immune thrombocytopenia purpura

destruction of IgG coated platelets

193
Q

Ribavirin

A

antiviral recommended for severe RSV

194
Q

hypersegmented neutrophil
hyposegmented neutrophil

A

Hypersegmented: Megaloblastic anemia 5+ lobes

Hypo segmented: MDS (Pseudo Pelger Huet cells, 2 lobes)

195
Q

monotonous lymphocyte with high mitoses and apotosis

A

burkitt lymphoma

196
Q

Mutation in B2 microglobbulin where the tumor cells fail to express MHC 1

A

reed steelburg cell. hodgkins
calls will also have a high level of PD1 to evade the immune system

197
Q

schilling test

A

B12 def

198
Q

Henoch-Schönlein purpura

A

hypersensitivity vasculitis- damages the vessel wall due to the
deposition of immune complexes.

child has triad: purpura(palpable), arthritis, abdominal pain

199
Q

normocellular marrow with increased numbers of megakaryocytes, some of which are slightly immature in appearance

A

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

200
Q

decongestants oral and nasal

A

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

201
Q

safety pin, bi polar

A

yersinia, Burkholderia pseudomallei

both are gram -

202
Q

Retro-orbital pain, fever, back pain, skin rash

A

bartonella

203
Q

methotreate antidote

A

Leucovorin
rescues bone marroe and helps with mouth soars

204
Q

Coxiella burnetii resoviour

what dz?

A

cattle, sheep, goats, tick

Q fever(flu, pneumonia, hepitits)

205
Q

ebola
family and category
vectors
where does microbe live in human

A

filovirus. -ssRNA
vectors: fruit bats, chimps, monkeys, deer(bush meat), human spread as well
lives in macrophages

206
Q

unique bi phasic life cycle
what dz

A

Chlamydia psittaci
Ornithosis (Psittacosis or Parrot fever)
inactive EB and active RB

207
Q

myobacteirum TB goes into the______ (first responce- innate and adaptive)

go through TB infection process

A

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

term 4 (13 decks)

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