Shit list Flashcards
1
Q
Karyorrhexis
A
DNA laddering, endonucleases cleave every 180bp in internucleosomal regions. Indicates apoptosis 222
2
Q
Apaf-1
A
Induces apoptosis; inhibited by Bcl-2 [overexpression of Bcl-2 prevents apoptosis = follicular lymphoma (t;14:18)222
3
Q
CD95
A
= Fas-R (on T-cells for negative selection)222
4
Q
Liquefactive necrosis
A
Lysosomal enzymes; brain, abscess, pancreas.223
5
Q
Casceous
A
Coagulative + liquefactive223
6
Q
Fat necrosis
A
Lipase; fat cells lose nucleus 223
7
Q
Fibrinoid necrosis
A
Immune (vasculitis), malignant HTN, pre-exlampsia 223
8
Q
Cells of acute inflammation
A
Neurophils, eosinophils, antibodies Outcome = recover, abscess, chronic inflammation 225
9
Q
Cells of chronic inflammation
A
Mononuclear (macrophages and lymphocytes), fibroblasts. Associated with BV formation, fibrosis, granulomas. Outcome = scarring or amyloidosis225
10
Q
Granulomas
A
Th1 –> IFN-g –> Macro –> TNF-a –> form and maintain granuloma 230
11
Q
Dystrophic calcification
A
Abscess, fat necrosis, infarcts, thrombi, schistosomiasis, Monkenberg, congenital CMV and toxo (TORCH - cerebral calcifications), psammoma bodies. In abnormal (diseased) tissues226
12
Q
Metastatic calcification
A
MC in kidney, lung, and gastric mucosa; because increase pH. In normal (healthy) tissues226
13
Q
Leukocyte extravasation
A
227
14
Q
Wound healing mediators
A
TGF-a - Epithelial and fibroblast GF; induce and maintain granulomas229
15
Q
Causes of Granulomas
A
230
16
Q
ESR
A
Increased: Pregnancy Decreased: HF and hypofibrinogenemia 230
17
Q
Dialysis-related amyloidosis
A
B2 microglobulin; can present as carpal tunnel 231
18
Q
Amyloidosis
A
AA = any inflammatory diseases (also FMF) Organ-spec: also meduallry CA thyroid cia calcitonin; AP via prolactin; Atria via ANP231
19
Q
Desmoplasia
A
Fibrous233
20
Q
K:L
A
3:1233
21
Q
Hamartoma
A
Disorganized tissue in correct place234
22
Q
Choristoma
A
Normal tissue in foreign place234
23
Q
SM tumours
A
Benign = leiomyoma Malignant = leiomyosarcoma 234
24
Q
Cachexia
A
IL-1, IL-6, TNF-a, IFN-g234
25
235-238
235-238
26
235-238
DO THEM AGAIN235-238
27
Psammoma
PSMM: Papillary thyroid Serous cystadenoma Mesothelioma Meningioma239
28
Carcinomas traveling hematogenously
Renal cell CA HCC Follicular thyroid ChorioCA234
29
Lineweaver-Burk
242
30
Lipoteichoic acid
Gram + Induces TNF-a and IL-1118
31
Outer membrane
Gram - Site of LPS: Lipid A induces TNF-a and IL-1; O = Ag118
32
Periplasm
Site of beta-lactamases118
33
Capsule
Used for vaccines Polysaccharide (except bacillus anthracis = d-glutamate) K Ag (except salmonella = Vi; s.pyogenes = M)118
34
Bacterial taxonomy
119
35
No cell wall
MycoPLASMA, ureaPLASMA Contain sterols119
36
Gram stain limitations
120
37
Stains
120
38
Special cultures
121
39
Obligate IC
122
40
Facultative IC
"Salamon Needs bruce, My Little France Legionaire Yersinia"122
41
Encapsulated Bacteria
122
42
Urease +
122
43
Catalase +
122
44
Exotoxins
124
45
Endotoxin
125
46
Gram +
127
47
Gram -
135
48
Zoonotic Bacteria
142
49
Virus trends
157
50
DNA Viruses
158
51
HSV-6
Roseola Infantum; 6th disease158
52
Parvo B19
Erythema infectiosum; 5th disease (slap cheek) 158
53
HPV warts
1, 2, 6, 11158
54
HPV cancer
16, 18, 31, 33158
55
EBV
Infects B-cells via CD-21 Downey cells = reactive CD8+ T-lymphocytes159
56
RNA viruses
161
57
HIV
Env: • GP 120 = attachment to CD4+; crosses placenta (FP neonate) • GP41 = fusion and entry Gag: p24 = capsid protein Pol: RT, asp protease, integrase [no proofreading --\> drift] CCR5 = macrophages; early infection CXCR4 = T cells; late infection168
58
A. Influenza
EMOP Epiglottitis can be in immunized kids Vaccine conjugated to diptheria toxin or another protein136
59
Pseudomonas
PSEUDDOm Ecthyma gangrenosum DM, burns, hot tub, CF137
60
Toxo Rx
Pyrimethamine + sulfadiazine (or clindamycin if sulfa allergy)150
61
Systemic micoses
Histoplasma = filled macrophage - Mississipi + Ohio Blastomycosis = broad based - Ohio Coccioidiomycosis = spherule with endospores - Cali Paracocciodiodomycosis = captains wheel - Latin America145
62
Gonorrhea and Chlamydia Rx
Ghono: ceftriaxone (3rd gen cephalosporin) Chlam: azithromycin or doxycyclin
63
Anthrax
Has D-glutamate capsule = poly PEPTIDE132
64
Post-viral pneumonia
A. Pneumo, S. aureus, H. influenza
65
Corynebacterium
Has intracellular pyrophosphate granules, stain blue and red Also + ELEK test130
66
Black eschar
Cutaneous anthrax or mucor sp.
67
Neutropenia
Increased risk of Gram -ve infections135
68
A. Aeruginosa
Exotoxin A (EF-2) contributes to ecthyma gangrenosum Also pyocyanin (ROS), elastase, PL-C137
69
Mycoplasma
PM is single PL layer righ in cholesterol No cell wall144
70
A. Botulinum
Heat LABILE Adults: 3Ds = diplopia, dystonia, dysphagia131
71
Hemolytic anemia
Pyruvate kinase deficiency = chronic hemolysis G6PD Deficiency = episodic
72
Legionella
Pneumonia (lobar and unilateral, severe) GI effects (watery diarrhea) CNS (confusion, HA) Increased in smokers/chronic lung disease High fever with relative bradycardia See PMNs but no bacteria (FI)137
73
IgA protease vs. Protein A
Protein A = s. aureus = bind Fc of IgG IgA Protease = SHiN = cleave IgA to allow binding to mucus membranes128+122
74
Rubella
Downward rash, post-auricular LAD TOGAvirus
75
Salmonella and yersinia
Can proliferate in LNs
76
A. Diff
Rx = metro (mild; systemic abs) or vanco (severe; static); recurrent or limited systemic = fidaxomycin 131
77
A. Perfringens
Alpha-toxin = lecithinase = Plase-C131
78
Mycoplasma
No cell wall, so must use ribosome inhibitors like macrolides or tetracyclins
79
Parvo B19
Aplastic anemia in sickle, fifth disease (erythema infectiosum), hydrops fetalis Only ssDNA, non-enveloped
80
Rabies
Bullet shaped Negri bodies Purkinje cells of cerebellum; hippocampal neurons Killed vaccine Binds Ach-R --\> retrograde up Bat, raccoon, skunk Fever/malaise --\> agitation, photophobia, hydrophobia , hypersalivation --\>paralysis ascending and flaccid and coma --\> death Spasms cause hydrophobia, aerophobia (fear of flying) and dysphagia 165
81
A. Aeruginosa
Hot tubs and burns! PSEUDDO = pneumonia, sepsis, externa, UTI, DM, drugs, Osteomyelitis Ecthyma Gangrenosum137
82
A. Viridans
Makes dextrans from glucose Binds to damaged valves, at fibrin-platelet aggregates on the damamged valve129
83
LVG
PainFUL Inguinal LAD (buboes)
84
Mitochondrial DNA
Synthesize mitochondrial things only: oxphos proteins, rRNA, tRNA68
85
GAS
Impetigo --\> PSGN Pharyngitis --\> PSGN and RHD PSGN = 1-5 weeks after RHD = 2-6 weeks after129
86
HiB Vaccine
Conjugated to diptheria Non-typable = no capsule --\> mucosal infections136
87
ParvoB19
ERYTHEMA INFECTIOSUM/FIFTHS DISEASE Circumoral pallor (because cheeks are red) [scarlet fever has cp too) Replicated in BM because of high prediliction for RBC precursors 158
88
Enteroviruses
Picornaviruses PECH (of PERCH) + EV-D68 and EV-71 PECH = poliovirus, echovirus, coxsackievirus, HAV Cause \>90% of aseptic meningitis cases (viral meningitis) Other causes: mumps, arboviruses (161), HSV-2161
89
EF-2
Corynebacterium diptheriae Pseudomonas aeruginosa124
90
S. pyo and H. flu markers
Strep pyogenes = PRY + (pyrrolidonyl arilamidase) H. Influenza = PRP+ (capsular antigen used in vaccines; polyribosylribitol phosphate)129 + 136
91
ToRCHeS
Blueberry muffin = To R C Eyes = To R Ears = R C S175
92
Klebsiella granulomatosis
STI granuloma inguinale Donovan bodies138
93
A. Neoformans
ID via: • Musicarmine stain • India ink • Latex agglutination • Growth on Saborard's 147
94
A. Diff
Toxin A = enterotoxin = watery diarrhea Toxin B = cytotoxin = colonic epithelial cell necrosis and fibrin deposition (via actin depolymerization) Detect TOXINs in STOOL via PCR131
95
Satellite phenomenon
H flu growing around s aureus on blood agarU963
96
Cat + coag - staph
S. Epidermidis = novobiocin sensitive S. Saprophiticus = novobiocin resistant 127
97
A. Diptheriae
Grey membrane with pharyngitis LAD (bull neck) Myocarditis Arrythmias 130
98
Rubella
Rash, fever, post-auricular/cervical LAD, POLYARTHRITIS/ARTHALGIAS163
99
Poliomaviruses
Class I, circular dsDNA JC: causes PML BK: in transplant pts, Ms = kidneys, causes nephropathy or hemorrhagic cystitis 158
100
DGI
Disseminated Gonococcal Infection Triad: polyarthritis, tenosynovitis, skin nodules (dermatitis) One of the MCC of septic arthritis in young sexually active people136
101
Gohno vs chalm arthiritis
ALSO seen post GI infections (salmonela, shigella, campylobacter, yersinia)144 + 432
102
PYR
Pyrrolidonyl arylamidase Strep Pyogenes Group D enterococci127
103
Superantigens
APC MHC-II -------beta-region of TCR on T-cell Beta region = variable region, so many T-cell lineages activated --\> massive IL-2 Macrophages release Il-1 (fever) and TNF-a (fever and hypotension)209
104
Endotoxins/LPS
Macrophages activated DIRECTLY by the LPS @ CD14/TLR4209
105
Ataxia Telangectasia
Kid with ataxia (cerebellar degen), occulocutaneous telangectasia, IgA deficiency (also IgE and IgG) so recurrent sinopulmonary infections. Increased AFP215
106
HIV bindings
Macrophages = 168
107
Leukocyte
227
108
A. Diptheriae
Stain granules with aniline dyes or methylene blue130
109
A. Aureus
Ferments mannitol127
110
Coag -ve staph
Epidermidis = novobiocin sensitive Saprophyticus = novobiocin resistant127
111
HLA
201
112
ADCC
NK cell expresses CD16 ---- Fc of IgG If no inhibitory signal via MHC-I binding, then ADCC initiated (perforin and granzymes) CD56 = unique marker201
113
Somatic hypermutation
Read FA201
114
Treg
CD3,4,25 FOXP3 Make anti-infl. cytokines202
115
Fas
Fas-L on CD8 Fas-R on target cell202
116
T cell activation
T-cell CD28 -----B7 (APC)203
117
B cell activation
B-cell CD40 ------CD40L (CD4 T-cell)203
118
Fab/Fc
Fab = idiotype Fc = isotype204
119
C3b
Opsonization AND clearance of immune complexes .: missing (C3 deficiency) = pyogenic sinus and URT infections (encapsulated organisms), and increased type III hypersensitivities (can't clear complexes)206
120
Superantigens
Causes massive cytokine release by Th cells?209
121
Endotoxins/LPS
Directly bind macrophages @TLR4/CD14 No Th involvement, just macrophage release209
122
Vaccines with HIV
MMR = only live-attenuated to HIV pt.210
123
Adenovirus 4 and 7 vaccine
Live NON-attenuated! Give orally, stimulate IgA in GIT, get killed by acid, make IgA to it on ALL mucosal sites 210
124
Component vaccines
HepB and HPV210
125
Blood reaction
Type I HST: • Allergic - antihist • Anaphylactic (IgA defic) - epi Type II HST • Febrile non-hemolytic - reaction to DONOR HLA antigens and WBCs • Acute hemolytic - intravascular = ABO; extravascular = foreign Ag on donor RBC212
126
Nitroblue tetrazolium dye
Fail to turn blue (stay yellow) = + for CGD215
127
Coagulase
i.e. s. aureus Activates prothrombin (--\> thrombin --\> activates fibrinogen --\> fibrin --\> clot --\> holds shit there)128
128
Lecithinase
A. perfringens131
129
Tryptase
Mast cell component, specific, indicates anaphylaxis
130
Downey cell
REACTIVE T-lymphocyte (CD8+)
131
Neutrophil chemotaxis
IL-8 C5a Kallicrine LT B4 PAF227
132
Paracortex
T cells and dencritic cells
133
CGD
Defect of NADPH oxidase See recurrent bacterial and funcgal (Cat +) infections Abscesses/granulomas215
134
Auto-reactive IgM
RHEUMATOID ARTHRITIS!!!!!
135
ADCC
Eosinophils NK PMN Macrophages201
136
Candidiasis
Th: prevent superficial candida infections PMNs: prevent dissemination of candida (phagocytose)147
137
Macrophage marker
CD14
138
Rifampin
Prophylaxis for meningococcal and h. flu B Actually treats TB and leprosy (tuberculoid)188
139
NADPH
Glutathione reductoin in RBCs, FATTY ACID SYNTHESIS , CHOLESTEROL SYNTHESIS, STEROID SYNTHESIS, P450 METABOLISM, RESPIRATORY BURST102
140
Differential cyanosis
Older child/adult: Cyanosis and clubbing of TOES Via long-term PDA (Eisenmenger) Infancy: Coarctation of the aorta with a PDA289
141
MSUD
Leucine --\> neurotoxic Isoleucine --\> metabolite --\> sugar smell 107
142
CMV esophagitis
Linear ulcers
143
Amiodarone
Class III (with 1-4 features) Does NOT have a risk for torsades (like the other class IIIs and IAs)309
144
A. Anthracis
Trimeric toxin: B-component: gets LF and EF into eukaryotic cells EF: activates AC (calmodulin-dependent) --\> edema LF: ZINC-dependent, protease, inhibits MAPK signalling --\> Apoptosis and dysfunction Also D-glutamate capsule!132
145
SLE
SLE can casue pancytopenia via auto-Abs • RBCs = warm agglutinins; positive Coombs, sphereocytes, extravascular hemolysis • Platelets: like ITP • Neutropenia less common433
146
Cranial nerve paths
475
147
Congenital long QT
Romano-Ward = AD, pure cardio Jervell and Lange-Nielsen = AR, sensorineural deafness283
148
Microtubule inhibitor side effects
Vincristine = neurotoxicity Vinblastine = bone marrow suppression411
149
PKU
Musty odor, posture/gait problems, eczema, intellectual disability, seizures, fair skinned, tremmors, hypopigmented basal ganglia \*probably from foreign country because we heel test at birth AR107
150
Bisphosphonates
"dronates" Ppi analong Make hydroxyapatite insoluble and interfere with Ocl activity For OP and Pagets and malignancy-induces hyper Ca AE: erosive esophagitis, jaw osteonecrosis, unchanged in urine445
151
Homocysteinuria
Intellectual disability, OP, marfanoid habitus, kyphosis, lens subluxation (down and in), thombosis (a and v), atherosclerosis108
152
Sarcoidosis s/s
Restrictive lung disease, lupus pernio, erythema nodosum, bells palsy, granulomas with schaumman and asteroid bodies, uveitis434
153
Polymyositis/dermatomyositis
Anti-Jo Anti-SRP Anti-Mi-2 CK Poly: endomysial, CD8, symmetric proximal weakness mc = shoulders Dermato: perimysial, CD4, malar, grottons, helicotrope, shawl and face435
154
Scleroderma
Diffuse = scl-70 (topo I); renal, pulm, GIT, cardio Limited = anti-centromere; skin of face and hands + CREST436
155
Skin terms
438
156
Cellulitis vs erysipelas
Cellulitis = deep dermis and subQ tissue Erysipelas = upper dermis and superficial lymphatics440
157
SSSS vs TEN
SJS 30%440
158
Erythema Multiforme
441
159
Erythema Nodosum
442
160
Acanthosis nigracans
Hyperinsulinemia OR visceral malignancies!442
161
Skin cancers
Basal cell: sun, UPPER lip, pallisading nuclei Squamous cell: UBV, chronic inflammation, arsenic, immunosuppression; face, hands, LOWER lip, ears; to LN but rare mets • Actinic keratosis = scaly precursor • Keratoacanthoma = variant, grows 4-6 weeks, spontaneous regression Melanoma: ABCDE, S-100, mets (depth = breslow = determining factor), BRAF V600E (Rx = vemurafenib = BRAF-Kinase inhibitor) • Superficial spreading • Nodular • Lentigo Malinga • Acral lentiginous ◦ Subungual (nail) = variant443
162
Ankylosing spondylitis
Sacroiliitis, anterior uveitis, aortic regurg, peripheral enthesitis, enthesitis of costovertrbral and costosternal joints --\> hypoventilation, 1% apical pulmonary fibrosis432
163
Xeroderma pigmentosum
NER defect --\> cant repair thymidine-dimers Dry skin with erythema, scaling, hypopigmented regions, and lentigos Later: skin atrophy, telangectasias, hypo and hyper pigmented areas443
164
ACL and PCL
ACL: • Connects from posterior femur to ANT TIBIA (medial side) • Prevents hyperflexion (anterior movement of tibia on femur) PCL: • Connect from posterior femur to POST TIBIA (fibular side) • Prevents hyperextension (posterior movement of tibia on femur)416
165
OI
Problem with bone matrix formation
166
Tongue muscles
XII • Hyoglossus = back and down • Genioglossus = out • Styloglossus = up (swallowing) X • Palatoglossus = lift posterior tongue for swallowing450
167
Bilateral acoustic neuromas
NF2451
168
Myelin origins
Oligodendrocytes = neuroectoderm Schwann = NCC452
169
Sensory receptors
452
170
NTs
453
171
Hypothalamus food
Increased lat increases fat 454
172
Circadian
Controls: NE, melatonin, ACTH, prolactin455
173
Drugs and sleep
Delta: alcohol, benz, barb (so can decrease night terrors/sleepwalking) REM: alcohol, benzo, barb, NE455
174
Basal ganglia
Striatum = caudate + putamen Lentiform nucleus = putamen + globus pallidus Lentiform = wilsons SNc = perkinsons Caudate = Huntingtons Internal capsule = lacunar infarct STN = hemiballismus Thalamus = thalamic/post-stroke syndrome 458
175
Dystonia vs myotonia
Dystonia = sustained contractions Myotonia = brief, suden contractions (liver or kidney failure; seizures)459
176
Parkinsons
A-synuclein --\> lewy bodies MTPT459
177
Huntingtons
CAG chrom 4 Dememtia, choreoform, depression, aggression Caudate degeneration - NMDA-R binding and glutamate mediated Ex vacuo hydrocephalus of frontal horns459
178
Kluver bucy
Assoc. with HSV-1461
179
Asomatognosia
Ignore half of world Via nondominant parietal-temporal cortex lesion461
180
Gerstmann syndrome
Agraphia, acalculia, finger agnodia, left-right disorientation, alexia dominant parietal-temporal cortex lesion461
181
Hippocampus
Anterograde amnesia461
182
PPRF lesion
Eyes look AWAY461
183
Frontal eye field lesion
Eyes look TOWARDS461
184
Blood supply
Cingulate gyrus (limbic) = ACA Corpus callosum (interhemispheric connection) = MCA462
185
Brain Autoregulation
Relies mostly on CO2 Theraputic hyperventilation = decrease CO2 .: "inc. O2" .: brain vasocontriction .: decrease acute increases in ICP Cerebral perfusion pressure (CPP) = MAP - ICP • If MAP decreases • If ICP increases • CAUSES decreased CPP --\> brain death463
186
1 Week post-infarct
Microglia have moved in --\> engulphing stuff --\> filled with lipid from myelin467
187
Fragile X
2nd MCC mental retardation (FMR-1 gene) CGG repeats MVP85
188
Measles
Lymphadenitis with Wethin-Finkeldey giant cells = fused lymphocytes, in background of paracortical hyperplasia Has HA!164
189
Opsoclonus-myoclonus
NEUROblastoma N-myc Abdominal mass, irregular, can cross midline Homer-writte rosettes Bombesin and neuron-specific enolase +ve325
190
Uncal herniation
CN3 Ipsi or contra CSTr Ipsi PCA = contralateral hemianopsia with macular sparing
191
Buspirone vs. Bupropion
Buspirone: • 5HT1A partial agonist • Rx for GAD • No sedation, addiction, tolerance, alcohol interactions, euphoria, hypnotic • JUST anxiolytic • Good for benzo abusing patients (decreased abuse potential) Bupropion: • Atypical antidepressant • Rx depression, smoking • No sexual dysfunction • JUST increases NE and DA via deceased reuptake • AE = amphetamine-like (tachycardia, insomnia), Ha, seizures (especially with history or annorexia/bulemia522 + 524
192
IMAGE
U794
193
Lysosomal storage diseases
111
194
Striatum
Caudate + putamen458
195
Central post-stroke pain syndrome
Neuropathic pain Via thalamic lesion Allodynia and dysthesia (abnormal sensations)465
196
Epidural and subdural areas
Epidural: CANNOT cross suture lines Subdural: CANNOT cross falx466
197
Intraparenchymal hemorrhage
Via: • HTN (MC) - BG + IC via bouchard microaneurisms • Amyloid angiopathy (lobar) • Vasculitis • Neplasm MC basal ganglia or internal capsule (but can be lobar)466
198
Hemorrhagic stroke
MC via HTN, antigoagulation, or cancer (abn. vessels bleed), reperfusion injury from vessel fragility467
199
Ischemic strokes
Thombotic = MCA via AS plaque Embolic = multiple vascular territories via a fib or DVT with PFO Hypoxic = watershed via CV surgeries (hypoperfusion or hypoxemia)467
200
Pseudotumour cerebri
468
201
Leg vs. arm location in spinal cord
DC: Leg medial CSTr: Arm medial ST: Arm medial469
202
Neurial and mysial inflammation
Neural: • Endoneurium = GBS • (perineurium = needs to be rejoined for surgery) Muscle: • Endomysium = polio AND polymyositis ◦ Anti-endomysium Abs in celiac disease • Perimysium = dermatomyositis
203
Riluzole
Rx for ALS (glutamate antagonist)471
204
Polio
CSF: WBCs and some protein (NO glucose change) Virus from throat or stool472
205
Brown sequard above T1
Horners via oculocympathetic pathway lesion472
206
Dermatomes
L1 = inguinal ligament L4 = kneecaps L1-L2 = cremaster L3-L4 = winks galore472
207
Galant reflex
Stroke side causes lateral flexion to that side472
208
Colliculi
• Inferior = auditory 474
209
CN nucleus lesions
5 = jaw TOWARDS 10 = uvula AWAY (collapse) 11 = weak CONTRA 12 = tongue TOWARDS 476
210
Cavernous sinus syndrome
• Horners • Variable opthalmoplegia (CN 6 most at risk!) • Decreased corneal sensation • [maybe decreased maxillary sensation if V2 affected] •
Via: • Pituitary tumour • Cavernous-carotid fistula • Cavernous sinus thrombosis via infection • Cavernous carotid aneurism 477
211
Basilar membrane
Base = thin = high frequencies Apex = wide = low frequencies477
212
Cholesteatoma
Overgrowth of desquamated keratin debris in MIDDLE EAR Can degrade ossicles 478
213
Bells palsy causes
• Idiopathic • Lyme • HSV-1 • HSV-3 (Ramsay-Hunt) • Tumour • DM • Sarcoidosis478
