standinpt2 Flashcards

1
Q

Dermatitis, enteritis, alopecia, adrenal insufficiency

A

B5 defiency (lack of CoA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Peripheral neuropathy of hands/feet, angiokeratomas, cardiovascular/renal disease. Disease and defiency and buildup and inheritance.

A

Fabry’s, alpha galactosidase A (enzyme), ceramide trihexose, XR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Central and peripheral demyelination with ataxia, dementia. Disease and defiency and buildup and inheritance.

A

Metachromatic leukodystrophy, arylsulfatase A, cerebroside sulfate, AR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Chylomicrons and picking up apolipoproteins

A

Start with B48, get E and C2 from HDL. E does uptake, C2 allows LPL to break down, B48 does nothing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What stains with Giemsa?

A

Chlamydia, borrelia, rickettsia, trypanosomes, plasmodium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What bug is cystine-tellurite plate

A

Diptheriae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What bug is lowenstein jensen agar

A

M TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cat positives?

A

Candida, listeria, aspergillus, pseudomonas, s aureus, serratia, e coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Urease positive bugs?

A

Crypto, h pylori, proteus, klebsiella, ureaplasma, nocardia, s epidermidis, s saprophyticus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What secretes Protein A?

A

Binds Fc region of Igs to prevent opsonization. Secreted by S aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How does shiga toxin work?

A

Inactivates 60S ribosome by removing adenine from rRNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which toxins affect cAMP? How?

A

Anthrax –>Edema factor–> Mimics adenylate cyclase enzyme to increase cAMP. Cholera –> Gs always on (ETEC heat labile is same). Pertussis –> disables Gi.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

5 toxins encoded in lysogenic phage

A

Shiga-like, botulinum, cholera, diptheria, erythrogenic of GAS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Only bacterium with polypeptide capsule

A

Anthrax (contains D-glutamate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Classic triad of chorioretinitis, hydrocephalus, and intracranial calcifications

A

Congenital toxo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which RNA viruses don’t replicate in the cytoplasm?

A

Influenza and retro

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

HIV structural genes. Which does attachment? Which does entry? Which is capsid? And which does reverse transcriptase, aspartate protease, and integrase?

A

Attachment = gp120
Fusion and entry = gp41
Capsid= gag (p24)
And those others = pol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Notched teeth, saddle nose, short maxilla, saber shins, CN VIII deafness

A

Congenital syphilis (though most die)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Macular rash over body after several days of high fever.

A

Roseola (HHV-6)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lymphogranuloma venereum vs granuloma inguinale

A

Venereum= c trachomatus. Inguinale = Klebsiella inguinale. Boht are painless, but venereum is more lymphatics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Toxo treatment

A

Pyrimethamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Ribavirin

A

Guanine-like, inhibits IMP dehydrogenase. RSV and chronic hep C. Teratogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Draw out HIV antivirals

A

Do it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Sulfonamides cause what teratogenic effect?

A

Kernicterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

CD14

A

Macs. This is what LPS activates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Ataxia, telangiectasia, what else would you expect to see?

A

Defects in ATM gene, coding for DNA repair enzymes. End up with IgA deficiency in addition to name, also increased risk of cancer. AR. Will see increased AFP!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Absent pus, delayed separation of umbilical cord. What is the problem?

A

Defect in integrin (CD18). LAD. Adhesion part is integrins

28
Q

When do you use alpha interferon

A

Hep B and C, Kaposi’s sarcoma, leukemias, malignant melanoma

29
Q

This part of the lymph node communicates with efferent lymphatics and contains reticular cells and macs.

A

Medulla

30
Q

This part of the lymph node houses T cells and is underdeveloped in patients with DiGeorge

A

Paracortex. In between follicles and medulla

31
Q

Anal canal above the pectinate line drains to which lymph node? Below pectinate line?

A

Internal iliac for above, below = superficial inguinal

32
Q

HLA A3

A

Hemochromatosis

33
Q

HLA DQ2/DQ8

A

Celiac

34
Q

What is the second signal for T cell activation for CD4 and CD8?

A

CD4 is B7 and CD28 interaction. CD8 is IL2 from CD4 Th1 cells

35
Q

What are the defenses to prevent complement activation on self cells? What happens when these go awry?

A

Decay accelerating factor (DAF)–> GPI anchored. What is deficient in paroxysmal nocturnal hemoglobinuria. And C1 esterase inhibitor (deficient in hereditary angioedema–> ACEi’s are contraindicated).

36
Q

Cytokines secreted by macs

A

1, 6, 8, 12, TNF alpha.

37
Q

CD3

A

Associated with TCR

38
Q

Patient presents with coarse face, cold abscesses, retained primary teeth, dermatologic problems. What would you expect the labs to show and what’s going on?

A

Hyper-IgE syndrome. Th1 cells can’t produce IFN-gamma, so neutrophils don’t respond to chemotactic stimuli

39
Q

Cyclosporine: MOA and AE’s

A

Binds to cyclophilins and makes a complex, then the complex blocks differentiation and activation of T cells by blocking calcineurin. Calcineurin is required for IL-2! Autoimmune. AE’s: nephrotoxicity, HTN, gingival hyperplasia and hirsutism (like phenyto

40
Q

Tacrolimus: MOA and AE’s

A

Inhibits calcineurin by binding to FK-binding protein (another name for drug is FK-506). Same toxicity as cyclosporine - the phenytoin ones (no gingival hyperplasia or hirsutism)

41
Q

Sirolimus (rapamycin): MOA and AE’s

A

Inhibits mTOR, blocking T cell proliferation in response to IL-2. AE’s: hyperlipidemia, thrombocytopenia, leukopenia. MINIMAL NEPHROTOXICITY! Differentiates from tacrolimus and cyclosporine.

42
Q

Azathioprine

A

Antimetabolite precursor of 6MP that interferes with the metabolism and synthesis of nucleic acids. Immunosuppressant.

43
Q

If you have a C3 deficiency, you have an increased susceptibility for what?

A

Type III hypersensitivity. Low C3b means low opsonization, so can’t remove complexes.

44
Q

2 areas most susceptible to ischemia in the kidney

A

Straight segment of proximal tubule (medulla), thick ascending limb (medulla)

45
Q

What are the factors responsible for neutrophil migration?

A

Chemotactic signals: C5a, IL-8, LTB4, kallikrein

46
Q

Mechanism of carbon tetrachloride damage

A

P450 breaks CCl4 –> CCl3 radical –> lipid peroxidation and membrane degeneration –> loss of apolipoproteins –> fat can’t leave liver –> fatty cahnge

47
Q

Free radical formation and handling in cells

A

O2 –> O2 radical by NADPH oxidase–> H2O2 by superoxide dismutase –> OH radical by catalase –> H2O by glutathione peroxidase I think. Note: H2O2 –> HOCl is done by MPO in neutrophils to kill stuff.

48
Q

How does iron poisoning present and mechanism?

A

Acute–> gastric bleeding. Chronic –> metabolic acidosis, scarring leading to GI obstruction. Cell death due to peroxidation of membrane lipids

49
Q

Senile amyloidosis

A

Due to deposition of transthyretin (TTR) in myocardium and other sites. Slow progression, often asymptomatic. This very same protein can be mutated and cause heritable amyloidosis leading to restrictive cardiomyopathy earlier in life.

50
Q

What allows for adherence to BM in neoplasia?

A

Increased laminin

51
Q

What allows for invasion of the BM in neoplasia?

A

Metalloproteinases and cathepsin D protease

52
Q

Desmoplasia

A

Fibrous tissue formation in response to neoplasm

53
Q

3 neoplasms associated with facial angiofibroma, seizures, and MR

A

Tuberous sclerosis: giant cell astrocytoma, renal angiomyolipoma, and cardiac rhabdomyoma

54
Q

2 neoplasms associated with Paget’s disease of the bone

A

secondary osteosarcoma and fibrosarcoma

55
Q

C-kit is for what type of tumor? Oncogene or tumor suppressor?

A

GIST. Oncogene

56
Q

Genes involved in melanoma (2), tumor suppressor or oncogene?

A

p16 and BRAF. P16 is tumor suppressor (like p53), BRAF is oncogene

57
Q

NF1 and 2, tumor suppressor or oncogene?

A

Tumor suppressor

58
Q

Describe the Rb pathway and what goes wrong with cancer.

A

Rb is usually bound to E2F which blocks transcription (this is in unphosphorylated state). When growth factor activates cyclin D which activates cyclin dependent kinase 4, phosphorylates Rb protein and E2F pops off and now can have transcription of enzyme

59
Q

Bombesin

A

Neuroblastoma, lung and gastric cancer marker

60
Q

Nitrosamines hit the ______ and cause _______

A

Stomach and gastric cancer

61
Q

Where does arsenic hit and what cancers does it cause?

A

Skin –> squamous cell and liver –> angiosarcoma. Arsenic fucks with lipoic acid to inhibit all the enzymes that need it (like pyruvate dehydrogenase) and oxidative phosphorylation, causing free radicals and decreased energy production

62
Q

Alkylating agents cause cancer where?

A

Blood: leukemia

63
Q

Which neoplasms make PTHrp?

A

Squamous of the lung, RCC, breast

64
Q

Which cancers make too much vitamin D?

A

Hodgkins

65
Q

Which cancers do EPO?

A

RCC, hemangioblastoma (associated with von hippel lindau), HCC, pheo

66
Q

Metastases to brain

A

Lung>Breast>GU>osteosarcoma>melanoma>GI