Smart Book Entry Friday March 28 Flashcards by Monica Fatorma

What species typically causes malaria in sub-Saharan Africa?

Plasmodium falciparum

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What species typically causes malaria in South and Central America?

Plamodium vivax

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What species of Plasmodium infects erythrocytes at all stages?

P. falciparum

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What species of Plasmodium infect young, larger erythrocytes?

P. vivax and P. ovale

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Which form of Plasmodium species form hypnozoites in the liver. Explain the implication of knowing this for medical practice.

Plasmodium vivax and P. ovale form hypnozoites in the liver that are dormant and reactivate weeks or months later.

Therefore these species must be treated with with a medication that targets the intraerythroctyic phase (eg, chloroquine) as well as the dormant hepatic phase (eg, primaquine) to ensure eradication and prevent relapse.

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When should CGD be suspected in a child?

Child presenting with recurrent infections by catalase-positive organisms (eg Staphylococcus aureus, Aspergillus)

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Describe the morphology of Gardnerella vagialis.

Facultative anaerobic, gram- variable rod.

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Dx features and characteristics of Gardnerella vaginalis.

Clue cells (squamous epithelia cells covered with bacterial organisms) are seen on wet mount microscopy or cytology

Associated with grayish-white, malodorous vaginal discharge

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Condition caused by Gardnerella vaginalis?

Bacterial vaginosis

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How are cerebral AVMs identified?

arteriovenous malformations are vascular malformations histologically characterized by a tangle of abnormal vessels, including large veins with thickened walls and irregular arteries.

Radiologic findings include abnormal vasculature with a “bag of worms” appearance and multiple dark flow voids

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Signs and symptoms of individuals who have cerebral AVMs?

intracrannial hemorrhage
headache,
seizures

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The SVC arises from which embryological vein structures?

common cardinal veins

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Nocardia is considered an facultative intracellular pathogen. T/F.

True

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What are some intracellular pathogens that are fungi?

Cryptococcus neoformans
Histoplasma capsulatum

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What are some common protozoal intracellular pathogens?

Crytosporidium parvum
Leishmania
Plasmodium
Toxoplasma gondii
Trypanosoma

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How are intracellular pathogens largely elminated?

via cell-mediated immune responses

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Some manifestations of Granulomatosis with polyangiitis.

Upper respiratory: sinusitis.otitis, saddle-nose deformity
Lower respiratory: lung nodules/cavitation
Renal: rapidly progressive glomerulonephritis
Skin: livedo reticiularis, non-healing ulcers

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Ways to diagnose granulomatosis with polyangiitis.

ANCA positive, particularly c-ANCA (PR3-ANCA)
Biopsy: necrotizing vasculitis with granulomas and little/no complement & immunoglobulin

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What is the most frequently used agent for chemoprophylaxis of meningococcal disease. (N. meningitidis)

Prophylactic rifampin

After an acute myocardial infarction, the mechanical complication of a papillary muscle rupture/dysfunction occurs in how many days?

Acute or within 3-5 days

After an acute myocardial infarction, the complication of an interventricular septum rupture occurs within what time fram?

acute or within 3-5 days

After an acute myocardial infarction, free wall rupture occurs within what time frame?

within 5 days or up to 2 weeks

After an acute myocardial infarction, left ventricular aneurysms occur within what time frame?

up to several months

What are the clinical findings of a papillary muscle rupture/dysfunction?

severe pulmonary edema, respiratory distress
new early systolic murmur (acute MR)
hypotension/cardiogenic shock

What are the clinical findings of those with an interventricular septum rupture?

* Chest pain * New holosystolic murmur * Hypotension/cardiogenic shock * Step up inn O2 level from RA to RV

What are the clinical findings of. those with a free wall rupture?

* chest pain * distant heart sounds * shock, rapid progression to cardiac arrest

What are the clinical findings in those with a left ventricular aneurysm?

* heart failure * angina, ventricular arrhythmias

Which coronary artery is typically occluded in cases of papillary muscle rupture/dysfunction?

right coronary artery

Which coronary artery is commonly occluded in cases of free wall rupture?

left anterior descending artery occlusion

Pathological process by which hypovolemic shock leads to an increase in ventilation.

Hypovolemic shock leads to reduced organ and tissue perfusion, which leads to lactic acidosis (metabolic acidosis) and a compensatory increase in ventilation (ie, compensatory respiratory alkalosis).

Rifaximin MOA.

nonabsorbable antibiotic that alters GI flora to decrease intestinal production and absorption of ammonia.

MOA of lactulose.

catabolized by intestinal bacterial flora to short chain fatty acids, lowering the colonic pH and increasing conversion of ammonia to ammonium.

What are the most commonly involved portion of the nephron in patients with ATN/

renal medulla receives the least blood supply; so the proximal tubules and the thick ascending limb of the loop of Henle

Where is the mental foramen?

Lower jaw

Nerve blocks to provide anesthesia to the cheek are frequently performed at what foramen of the skull?

infraorbital foramen

Integrase inhibitor MOA?

disrupts HIV genome integration, preventing synthesis of viral mRNA

Acute closed-angle glaucoma is a side effect commonly associated with what drug that can also be used to treat bradycardia?

atropine

Common withdrawal symptoms of stimulants (eg, cocaine, amphetamines).

increased appetite, hypersomnia, intense psychomotor retardation, severe depression ("crash")

Acute otitis media can be caused by which organisms? Which is the most common cause in young children age 6 months to 2 years?

* Streptococcus pneumoniae * Haemophilus influenzae (non-typeable) * Moraxella catarrhalis S pneumo most common in this age group

Paroxysmal breathlessness and wheezing in a young patient that are unrelated to ingestion of aspirin, pulmonary infection, inhalation of irritants, and/or exercise should raise a strong suspicion for what condition?

(extrinsic) asthma

What are the classic sputum findings in patients with asthma?

* eosinophils and Charcot-Leyden crystals. * Eosinophils are recruited and activated by IL-5 secreted by Th2 type T cells

Some clinical features of PCOS?

Polycystic ovary syndrome * Androgen excess (eg, acne, male pattern baldness, hirsutism) *oligoovulation or anovulation (eg, menstrual irregularities * obesity * polycystic ovaries on ultrasonography

Pathophysiology behind PCOS?

* inc. testosterone levels * inc. estrogen levels * LH/FSH imbalance

What type of diverticulum is Meckel's diverticulum?

True diverticulum consists of all 3 layers of the intestinal wall (mucosa, submucosa, and muscularis)

Give examples of pseudodiverticulum.

Zenker esophageal diverticula, diverticulosis

Describe the mucosal layers involved in pseudodiverticulum.

mucosa and submucosa

Some major signs and symptoms of Type 1 DM?

* polydipsia, polyuria * polyphagia * Weight loss * blurred vision * ketoacidosis