Week 2 Flashcards
Describe the culture characteristics of Listeria (4).
Gram positive rod, tumbling motility (actin rockets), grows at 2.5C, narrow zone of β hemolysis on sheep agar.
What is CVID?
A defect in B cell maturation such that antibody-secreting plasma cells are deficient. Causes deficiency in immunoglobulin, increased risk of autoimmune dz, and lymphoma
What is the effect of IL-12R deficiency?
Decreased TH1 response. This results in disseminated mycobacterial infections.
What is HyperIgE (Job) syndrome?
Th1 cells fail to produce IFNγ. Features are coarse facies, staph abscess, retained primary teeth, hyperIgE, and eczema
What is leukocyte adhesion deficiency?
Absent LFA-1 integrin on phagocytes. Results in recurrent bacterial infection, absent pus formation, retained umbilical cord, and neutrophilia.
What is Chediak-Higashi syndrome?
Microtubule dysfunction with failure to form phagolysosomes (LYST gene). Susceptibility to staph and strep infections. Partial albinism and peripheral neuropathy.
What is neuroleptic malignant syndrome? What are the s/s (4)
It is caused by antidopaminergic activity of neuroleptics (esp on D2 receptors). Causes hyperthermia, autonomic instability, hyperthermia, and altered mental status.
What drugs belong to the neuroleptic family?
Haloperidol and -azines: fluphenazine, thioridazine, chlorpromazine
What are the main features of osteogenesis imperfecta? What is the defect?
Fractured bones, blue sclerae, and poor wound healing. Defect in collagen I
What do structures do the bronchioles lack that the bronchi have?
Goblet cells, glands, cartilage
What leads to the formation of a cleft lip?
Failure of 1 of the maxillary prominences to fuse with the intermaxillary segment.
What leads to the formation of a cleft palate?
Failure of the palatine shelves to fuse with one another or with the primary palate (intermaxillary segment).
What are the side fx of niacin?
Hyperuricemia, hyperglycemia, and red, flushed face that decreases with aspirin use or prolonged use.
What are the reversible changes observed in cell death (5)?
Chromatin clumping, cellular swelling, glycogenation, fatty change, polysome detachment
What are the irreversible changes observed in cell death (4)?
Plasma membrane damage, nuclear fragmentation (pyknosis, karyorrhexis, karyolysis), lysosomal rupture, mitochondrial permeability.
What are the possible treatments of glaucoma?
Decrease synthesis of aqueous humor by the ciliary body epithelium with β blockers (timolol) or acetazolamide.
Increase outflow of aqueous humor by cholemimetics (carbachol, pilocarpine) or PGF2α analogs (letanoprost, unoprost, travaprost)
How is gardnerella vaginalis treated?
Metronidazole
What are the features of koilocytes?
Dark-staining nucleus, enlarged nucleus, convoluted nuclear membrane, perinuclear halo
What are the maternal and neonatal symptoms of Toxoplasmosis?
Maternal: usually asymptomatic. Neonate: chorioretinitis, hydrocephalus, intracranial calcifications.
What are the maternal and neonatal symptoms of Rubella?
Maternal: rash, LA, arthritis. Neonate: deafness, cataracts, PDA, sometimes blueberry muffin rash
What are the maternal and neonatal symptoms of CMV?
Maternal: asymptomatic or mono-like illness. Neonate: Deafness, seizures, petechiae, blueberry muffin rash
What conditions produce an S4 heart sound?
High atrial pressure associated with ventricular hypertrophy.
What bacteria contain a antiphagocytic d-glutamate capsule?
Bacillus anthracis
What are the pathogenic factors of bacillus anthracis?
Edema factor is a calmodulin-dependent adenylate cyclase. It upregulates cAMP, inhibits PMN function, and causes massive edema.
Lethal factor inhibits protein kinases and induces macs to release IL-1 and TNFα
Protective antigen is the B subunit.
What drugs can cause aplastic anemia?
Benzenes, chloramphenicol, antimetabolites, and alkylating agents.
What infections can cause aplastic anemia?
Parvovirus B19, EBV, HIV, HCV
What is acanthosis and its associated condition?
Thickening of the spinosum layer; psoriasis
What is dyskeratosis and its associated condition?
Abnormal premature keratinization of keratinocytes; squamous cell ca.
What is hyperparakeratosis and its associated condition?
Retention of nuclei in stratum corneum. It signifies incomplete keratinization. Actinic keratoses.
What is hypergranulosis and its associated condition?
Abnormal granulation in the stratum granulosis. Lichen planus
What are the characteristics of neuroblastoma (7)?
Most common extracranial childhood cancers. Children under 2, small blue round cells, retroperitoneal mass, anorexia, weight loss, increased HVA, nMYC amplification.
What paraneoplastic syndrome is associated with neuroblastoma?
Opsoclonus-myoclonus: non-rhythmic conjugate eye movements associated with myoclonus
What metastases are associated with neuroblastoma?
Dumbbell tumor (epidural), bone marrow, liver, skin, periorbital
What are the diseases of schistoma? How is it treated?
Granulomatous inflammation and fibrosis of the spleen, liver, GI tract, and bladder. Treated w/ praziquentel.
Axillary n. injury (spinal nerves, cause of injury, motor deficit, sensory deficit, physical sign)
C5, C6. Caused by fracture of the surgical head of the humerus. Decreased deltoid action (abduction); decreased sensation over deltoid; flattened deltoid
Radial n. injury (spinal nerves, cause of injury,motor deficit, sensory deficit, physical sign)
C5-C8. Fracture of the humeral shaft or prolonged axillary compression. BEST extensors (brachialis, extensors of wrist and fingers, supinators, triceps); dorsum of hand and thumb, posterior arm; wrist drop.
Proximal median n. injury (spinal nerves, cause of injury, motor deficit, sensory deficit, physical sign)
C5-T1. Supracondylar injury to the humerus. Thumb opposition; lateral 3 1/2 fingers, thenar eminence; ape hand (thenar atrophy and loss of thumb opposition)
Distal median n. injury (spinal nerves, cause of injury,motor deficit, sensory deficit, physical sign)
C5-T1. Carpal tunnel syndrome. Flexion of lateral fingers and wrist; lateral 3 1/2 fingers; ulnar claw - ulnar deviation on wrist flexion.
Proximal ulnar n. injury (spinal nerves, cause of injury,motor deficit, sensory deficit, physical sign)
C8, T1. Lateral epicondyle injury (funny bone). Flexion of medial fingers; medial 1 1/2 fingers, hypothenar eminence. Radial claw.
Distal ulnar n. injury (spinal nerves, cause of injury, motor deficit, sensory deficit, physical sign)
C8, T1. Hook of the hamate injury. Extension of 4th and 5th fingers (lumbricals), abduction and adduction of fingers (interossei), adduction of the thumb; no sensory deficit. Hand of benediction.
Musculocutaneous injury (spinal nerves, cause of injury, motor deficit, sensory deficit, physical sign)
C5-C7. Upper trunk compression. Loss of elbow flexion (biceps brachii, brachioradialis, coracobrachialis). No sensory deficit.
Treatment of coag (-) staph.
Vancomycin w/ or w/o rifampin and/or gentamicin
What are the symptoms of systemic mastocytosis?
GI: increased gastric acid secretion, inactivation pancreatic enzymes, diarrhea
CV: tachycardia, flushing, syncope
Bronchospasm
Skin: urticaria and pruritus
For what enzymes is lipoic acid a cofactor?
Pyruvate DH, αKG-DH, branched chain ketoacid DH
What changes are seen 12 hours after a stroke?
Macroscopic changes: hypodense region on CT w/ edema and loss of gray-white junction
What changes are seen 36-48 hours after stroke?
Microscopic changes: irreversible injury to neurons (red neurons). Infiltration with PMNs and then macs
What changes are seen 3-5 days after a stroke?
Neurons disintegrate and their fragments are taken up by macs (lipid sin the cytoplasm)
What changes are seen 2 weeks after a stroke?
Gliosis: cystic space lined by astrocytes and new capillaries.
What are the outcomes for hepatitis B infection?
60-65% are subclinical
20-25% have acute hepatitis that resolves
5-10% become chronic carries
4% have chronic hepatitis, 20-30% of which develop cirrhosis.
What is the formula for a 95% confidence interval?
Mean ± 1.96*σ/√n
What is metyrapone test?
Metyrapone is an inhibitor of 11β hydroxylase, thus inhibiting cortisol production. Negative feedback is removed from ACTH. It is used to detect an interruption in the HP axis. In a normal individual there is elevated 17(OH)steroids.
What are the normal pressures of the right ventricle?
5 and 25
What are the normal pressures of the pulmonary artery?
10 and 25
What are the normal pressures of the left atrium?
2 and 12
What are the normal pressures of the left ventricle?
130 and 10
What are the normal pressures of the aorta?
130 and 70
What are the signs and symptoms of liporotein lipase deficiency (6)?
Elevated chylomicrons, hyperlipidemia, skin xanthalesmas, lipema retinalis, pancreatitis, hepatosplenomegaly
What drug can be used to help diagnose lipoprotein lipase deficiency?
Heparin, because normally it liberates lipase bound to endothelium, which encourages the clearance of TGs from circulation.
Describe the pathology of mucormycosis.
It tends to infect the paranasal sinuses in patients w/ DKA and immunosuppression. The fungi proliferate in the blood vessels when abundant glucose and ketones are available.
How is volume of distribution calculated?
= drug in the body/plasma drug concentration
What is the calculation for loading dose?
Cp * Vd / F
What is the calculation for maintenance dose?
Cp * CL / V
What drugs have antimuscarinic side effects?
atropine, mertazapine, TCAs
What conditions have a type IV hypersensitivity reaction (7)?
Contact dermatitis, T1DM, Guillain-Barre, Multiple sclerosis, Hashimoto’s, GVH, PPD
What is the calculation for attributable risk percent?
=(1-RR)/RR
What is the calculation for attributal risk?
[a/(a+b]-[c/(c+d)]
What is the calculation for type I error?
b/(b+d)
What is the calculation for type II error?
c/(a+c)
What is methylmalonic acidemia?
Methylmalonic acid fails to isomerize to succinyl CoA.
What are the treatment options for rheumatoid arthritis? What are the features of each?
NSAIDs for acute relief. Corticosteroids provide the most rapid relief and are very potent. Disease modifying drugs (methotrexate, sulfasalazine, hydroxychloroquine) take weeks for a response
What are the pathogenic factors for pertussis (4)?
Pertussis toxin (activates adenylate cyclase and kinases), extracellular adenylate cyclase (interferes w/ H2O2 & WBC chemotaxis), hemagglutinin, and tracheal cytotoxin.
What factors are in cryoprecipitate?
Fibrinogen, CF VIII, and CF XIII
What is the clinical significance of the first dose of ACE-inhibitors?
First dose hypotension. It is caused by a decreased venous return to the heart, which induces vagally mediated hypotension and bradycardia. Potentiated by hyponatremia or hypovolemia due to concurrent thiazide or loop diuretic use.
What is lamotrigine?
It is used for simple, complex, and tonic-clonic seizures. It blocks VG Na channels.
What is the most dangerous side effect of lamotrigine?
Steven Johnson syndrome
What complaints must be present for somatization disorder?
4 pain, 2 GI, 1 sexual, 1 pseudoneurologic
What is conversion disorder?
Sudden loss of sensory or motor function. It usually follows an acute stressor. The patient is aware but indifferent to the symptoms.
What is pain disorder?
Prolonged pain with no physical findings. Psychologic factors play a role in severity, exacerbation, and maintenance.
What can be used in the treatment of PCOS?
Weight loss and oral contraceptives. If the patients wants to be pregnant, clomiphene can be used.
What is the MOA of clomiphene?
It is a SERM that prevents negative feedback inhibition on the hypothalamus by circulating estrogen, which increases FSH & LH.
