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Test 18 Flashcards

1
Q

sore throat, malaise, lymphadenopathy, myalgias, slenomegaly, fever

A

infectious mono

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2
Q

This virus infects the pharpyngeal mucosa and tonsillar crypts, gains access to the blood stream, preferentially infects B lymphocytes by binding to CD21.

A

EBV

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3
Q

How does the IS respond to EBV infected cells?

A

CD8 T cells (cytotoxic T lymphocytes), clonally expand expand to destroy virus infected cells

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4
Q

Larger cells w/ abundant cytoplasm and eccentrically placed nucleus + cell membrane that conforms to the borders of neighboring cells

A

Atypical lymphocytes seen in EBV

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5
Q

What cell surface marker is expressed on monocytes and mphages and serves as a receptor for LPS (LPS binding to this receptor activates the mphage)

A

CD14

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6
Q

What do the cardinal veins give rise to?

A

SVC and other constituents of the venous circulation

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7
Q

What happens to the umbilical veins, vitelline and cardinal veins during development?

A

umbilical veins= degenerate

vitelline veins= become the veins of the portal system

cardinal veins= veins of systemic circulationg

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8
Q

What is the main mechanism by which increases in myocardial O2 demand are satisfied?

A

Hypoxia and adenosine accumulation increase cardiac perfusion

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9
Q

Where does most coronary venous blood drain into?

A

coronary sinus in the right atrium (the remainder drains into the chambers of the heart

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10
Q

What three features distinguish heart circulation from blood flow to skeletal muscle and viscera?

A
  1. Heart is perfused during diastole and consumes 5% of CO
  2. Myocardial O2 requirement is high (extracts 90%)
  3. Coronary flow is regulated by local metabolic factors (hypoxia and adenosine accumulation)
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11
Q

What part of the heart is prone to ischemia?

A

endometrium

Myocardial contraction during systole compresses the coronary arteries and disrupts blood flow (contraction is highest in the endocardium leading to severe coronary vessel compression)

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12
Q

Hypo-hyperpigmeneted skin patches that become more visible after tanning

A

Malassezia furfur causes PITYRIASIS VESICOLOR (stratum corneum)

*more common in hot humid climates

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13
Q

KOH scraping show spaghetti and meatballs on light microscopy

A

Malassezia furfur

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14
Q

Two toxins act by ribosylating and inactivating EF2, inhibiting host cell protein synthesis and causing cell death?

A

Diptheria toxin= C. Diptheriae

Pseudomonal exotoxin A= Exotoxin A

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15
Q

Superantigen that acts locally in the GI tract causing vomiting

A

Enterotoxin= S. Aureus

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16
Q

Superantigen that stimulates T cells leading to widespread cytokine release and shock (IL-1, TNF alpha)

A

TSS toxin

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17
Q

Induces actin depolymerization leading to mucosal cell death, necrosis of colonic muscosal surfaces and pseudomembrane formation

A

Toxin B= C. Diff

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18
Q

Blocks presynaptic release of Ach at NM jxn resulting in flaccid paralysis

A

Botulinum toxin= c. botulinum

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19
Q

Disinhibits AC via G ADP ribosylation> increased cAMP> increased histamine sensitivity and phagocyte dysfxn

A

Pertussis toxin= bordatella pertussis

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20
Q

Acitvates AC via G ADP ribosylation> increased cAMP> secretory diarrhea, dehydration, electrolyte imbalances

A

cholera toxin= v. cholerae

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21
Q

Unconscious manifestations of neurologic sxs w/ no pathophyisiological manifestations often after significant life stress

A

converseion disorder

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22
Q

most lateral of hte distal carpal bones, thumb “swings on it”

A

trapezium

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23
Q

What bone lies at the center of hte wrist?

A

capitate

24
Q

What bone is located at the proximal medial wrist and with the lunate forms the small articular surface between teh ulna and carpal bones?

A

triquetrum

25
Q

What type of fall classically causes lunate dislocation?

A

fall on oustretched hand

26
Q

cause of avascular necrosis of proximal scaphoid fx fragment

A

lunate dislocation that also causes fx of scaphoid

27
Q

Noninfective glycoprotein component of HVB envelope that forms spheres and tubules 22 nm in diameter

A

HBsAg (secreted by infected hepatocytes)

28
Q

Nucleocapsid core protein taht resides in hepatocytes and assembles virion

A

HBcAg

29
Q

Nucleocapsid core and precore protein that is a marker of high infectivity. Core component resides in hepatocytes and assembles virion, while precore is secreted in the blood

A

HBeAg

30
Q

TRanscriptional transactivaitor of viral gens from X region that is necessary for viral replication

A

HBx

31
Q

What type of mutations results ina glutamate residue being substituted by lysine in the beta globin chain?

A

Missence mutation causing hemoglobin C (HbC in both beta chain)

Hb A> HbS> HbC

32
Q

1 HbS allele and 1 HbC allele

Asymptomatic pt w/ mild hemolytic anemia and splenomegaly

A

Hemoglobin SC disease

33
Q

Mental retardation, facial dysmorphism, cardiac defects

A

Down Syndrome (usually caused by extra chromosome 21– trisomy)

34
Q

What are other less common cuases of Down Syndrome?

A

Robertsonian translocations mosaicism

35
Q

What is a Robertsonian translocation?

A

46 chrom, but extra arm of chrom 21 is attached to another chrom (translocation)

36
Q

How can mosaicism cause Downs?

A

Pts have 2 cells lines: one w/ a normal genotype and one w/ trisomy 21

(no maternal association, post fertilization mitotic error)

37
Q

Causes of secondary hyperaldosteronism

A

renovascular disease
malignant HTN
renin secreting tumors

38
Q

HyperTN, hypokalemia and muscle weakness can be attributed to…

A

elevated serum adlosteorne levels

39
Q

Increased renin and aldosterone

A

secondary hyperaldosteronism

40
Q

A pt who is a known HBV carrier presents to your office w/ malaise, weight loss and abdominal fullness. CT reveals a liver mass and increased AFP.

A

Hepatocellular carcinoma

41
Q

carcinoma assocaited w/ HBV infeciton

A

Hepatocellular

42
Q

What triggers neoplastic changes in HBV?

A

integration of viral DNA into genome of host hepatocytes

43
Q

Increased incidence of Burkitt lymphoma and nasopharyngeal carcinoma

A

EBV infection

see atypical lymphocytes on blood smear CD21

44
Q

measure of association between exposure and outcome

A

Odds ratio

45
Q

Formula for OR?

A

OR= ad/bc

46
Q

RR formula

A

a/ (a+b)/
c/ (c+d)

risk of disease in hte exposed divided by risk of disease in the non exposed

47
Q

Difference in risk between exposed and unexposed

A

AR

A/ (a+b) - c/ (c+d)

48
Q

Bean shaped gram negative cocci that causes meningitis

A

N. meningitidis

49
Q

How does N. meningitidis gain access to the CNS?

A 
respiratory droplets>
colonizes nasopharynx>
bloodstream>
choroid plexus>
meninges
50
Q

What is the second MC cause of acute bacterial meningitis in adults in the US?

A

N. Meningitidis

51
Q

Which neisseria ferments maltose and glucose?

A

MeninGococci ferment Maltose and Glucose

52
Q

meningococcemia
meningitis
WF syndrome

A

n. meningococci

53
Q

Pharynx> lymphatics> meninges

A

H. Influenza meningitis in infants and children

54
Q

Middler ear> contiguous tissues>

meninges

A

S. Pneumoniae gains acces to CNS during acute ear infection

55
Q

Traumatic wound>
leak CSF>
meninges

A

S. Aureus meiningitis/CNS abscess (fullowing penetrating skull trauma or neurosurgery)

56
Q

Primary lung focus>
blood >
meninges

A

Myobacterium TB meningitis or S. pneumoniae meningitis

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