USMLE Flashcards
MHC class 2 deficiency
defect: failure of MHC class 2 expression, defects in transcription factors
T cells present and responsive to nonspecific mitogens, no GVHD, deficient in CD4+ T cells, hypogammaglobulinemia.
clinically observed as a severe combined immunodeficiency
halothane- important post-surgical complication
hepatitis
tabes dorsalis
degeneration of dorsal columns and dorsal roots. Loss of pain sensation and peripheral reflexes, impairment of vibration and position senses, progressive ataxia
goes with tertiary syphilis
mycosis fungoides
cutaneous T-cell lymphoma
malignant T cells densely infiltrate the superficial dermis and epidermis –> plaques and nodules.
can look like fungal infection
swiss cheese model
major catastrophic systems failures often reveal multiple, smaller failures –> the hazard
Klinefelter syndrome
47 XXY
sparse body hair, feminine body habitus, gynecomastia, small testes, reduced fertility
halinized seminiferous tubules without sperm
decreased inhibin and testosterone, increased LH, FSH, estrogen
what gallstones in hemolytic disorders?
calcium bilirubinate (black pigmented)
Chagas disease
brazil
cardiomyopathy/ failure and megaesophatus/ megacolon
bacillus anthracis shape/ stain
boxcar-shaped
gram positive
aerobic
spore-forming
treat with cipro or doxy
urachus obliterates and becomes what?
median umbilical ligament
Dressler syndrome
utoimmune post-MI phenoenon –> fibrinous pericarditis
prefer to sit upright and lean forward
friction rub
4-6 weeks after MI
ECG changes with diffuse ST elevations in many limb leads
In electron micrographs of cilia we see
9 doublets + 2
microtubules
hypokalemia and metabolic alkalosis suggests
use of a loop diuretic such as furosemide
increases acid excretion
Hyper IgM syndrome
high levels of IgM, depressed IgA, IgG and IgE
can’t do isotype switching, most commonly because of hte absence of CD40L on TH2 cells
treatment of Mycoplasma pneuminiae and mechanism
Macrolies (azithromycin)
inhibit the translocation of peptidyl tRNA from the acceptor site to the donor site of the 50S subunit
digoxin and loop diuretic
digoxin toxicity increased with hypokalemia/ hypomagnesemia brought on by furosemid, torsemide, or ethacrynic acid
first manifestation of cystic fibrosis
meconium ileus- obstruction
gastric adenocarcinomas/ infiltrating lobular carcinoma of the breast mutation
E-cadherin (CDH1)
impacts adherens junctions
disfiguring skin lesions, multinucleated giant cells, anesthesias. What? Cell marker?
lebrosy
CD14 (modified macrophages)
post-strep glomerulonephritis. Looks like on biopsy?
subepithelial humps
can follow pharynx OR skin infection
toxoplasmosis shape
necrotic, focally hemorrhagic lesions containing both large, round encysted bradyzoites and free, crescent-shaped tachyzoites toward the edge of the lesion
treat with pyrimethamine and sulfadiazine
blood supply to the head of the femur arises from
medial circumflex femoral artery
lines of Zahn
pre-mortem thrombus
tri-cyclic anti-depressants
block NE and 5-HT reuptake
side effects: anticholinergic, sedation, lower seizure threshold
examples: amitriptyline, imipramine, nortriptyline, desipramine
hormone secreted during severe hypoglycemia
epinephrine
most common CNS tumor
metastatic
what’s happening in Type 4 hypersensitivity?
TH1 cells sensitized to haptenated cells make cytokines that activate cytotoxic T lymphocytes and macrophages –> tissue damage
rhomboid crystals seen on polarization
pseudogout: calcium pyrophosphate.
Gout is needle-shaped, negatively birefringent (yellow) cristals
seborrheic keratoses - microscopic
keratin-filled cysts, aka pseudo-horn cysts
anterior pituitary hormones
TSH, ACTH, LH, FSH, GH, prolactin
blood flow is slowest where?
capillaries
decreased sesation over right face and body - all sensory modalities- implies lesion where?
left ventral posterior thalamus
long thoracic nerve innervates what?
serratus anterior
gonorrhoeae growth medium, characteristics?
chocolate agar (thayer martin)
gram-eg
oxidase positive diplococcus
has over 1 million variants of pili –> no immunity
LCAD deficiency
–> fasting hypoglycemia and hypoketosis
muscle weakness and cardiomyopathy
encapsulated organisms to vaccinate against in sickle cell
strep pneumo
salmonella
haemophilus (younger kids, commonly given)
metformin side effect
lactic acidosis, esp. w/ renal insufficiency
metaclopromide
prokinetic agent that stimulates the intestinal tract
do not give with bowel obstruction
cytokine that stimulates macrophages
IFN-gamma
APL translocation
t(15;17) with Auer rods
skin scrapings of HSV have
intranuclear inclusion bodies
drugs that decrease aldosterone
ACE inhibitors (like enalapril)
Paget disease of the breast goes with
adenocarcinoma
how do we make dx of pyloric stenosis?
abdominal ultrasound
bartonella henselae
gram negative
papule/ pustule, regional lymphadeonopathy
stellate granulomas
treat with quinolones, doxycycline or azithromycin (preggos)
Paternity testing– what kind?
microsatellite testing
biggest predisposing risk factor for TB?
AIDS
