Week 3 Flashcards
What are the manifestations of Chediak-Higashi syndrome?
Giant lysosomal inclusions, ablinism, neuro defects, susceptibility to staph and strep.
What are the treatment options for gout?
1st line for acute: NSAIDs; 2nd line for acute: colchicine; Prophylaxis: uricosurics (for under-excretors) or xanthine oxidase inhibitors.
What is 7α hydroxylase?
It converts cholesterol to bile acids. Inhibition (by fibrates) reduces the conversion, resulting in excess cholesterol in the bile.
What are S/S of opiate withdrawal (4)?
Piloerection, dilated pupils, diaphoresis, fever.
What is the host defense against giardia?
Secretory IgA prevents adherence to duodenal and jejunal mucosa.
Describe the morphologic features of silicosis
Eggshell calcification of hilar nodes and birefringent particles surrounded by collagen.
Describe the morphologic features of beryllosis
Noncaseating epithelioid granulomas.
What is malignant hyperthermia? How does it present (5)?
It occurs due to hypersensitivity of skeletal muscles to inhaled anesthetics. Its due to an AD defect in the ryanodine receptors. Hyperthermia, tachycardia, rigidity, hyperkalemia, myoglobinuria.
How is malignant hyperthermia treated? What is its MOA?
Dantrolene (a muscle relaxant) It prevents Ca release from SR of skeletal muscle.
What is the HAART regimen? When is it initiated?
2 NRTIs + 1 NNRTI or 1 PI or 1 integrase inhibitor. Initiated w/ AIDS defining illness, CD4 <350, or high viral load.
Describe the inflammation of polyarteritis nodosa. What artery is always spared?
Segmental, transmural, necrotizing inflammation to small and medium-sized arteries. Fibrinoid necrosis is apparent. Pulmonary arteries are spared.
Subdural hematoma (blood vessel involved, location, clinical manifestation, CT)
Bridging cortical veins, between dura and arachnoid mater, gradual onset of HA and confusion, crescent-shaped hematoma.
What is lymphangiosarcoma? What condition is it associated with?
Malignancy of the endothelial lining of lymphatic channels. Assoc’d w/ prolonged lymphedema.
Name the serum marker: pancreatic cancer
CEA and CA19-9
Name the serum marker: ovarian cancer
CA-125
Name the serum marker: malignant epithelial tumor
CA-125
Name the serum marker: malignant melanoma
S-100
Name the serum marker: neural tumor
S-100
Name the serum marker: astrocytoma
S-100
Name the serum marker: metastasis to bone
Alk phos
Name the serum marker: neuroblastoma
Bombesin
Name the serum marker: lung cancer
Bombesin
Name the serum marker: gastric cancer
Bombesin
What are gene enhancers?
Stretches of DNA that alter transcription by binding transcription factors. They can be located anywhere upstream, downstream, or even within a gene.
Describe the flow of CSF.
Lateral ventricles (foramen of Monroe), 3rd ventricle (cerebral aqueduct), 4th ventricles (foramen of Luschka and foramen of Magendie) subarachnoid space.
What bugs can cause aspiration pneumonia? What ABx covers them?
Anaerobes (bacteroides, prevotella, fusobacterium, peptostreptococcus) Covered by clindamycin.
What is ergonovine? What is its clinical significance?
It stimulates α adrenergic and serotonergic receptors to cause vasoconstriction. It is used to induce angina for the Dx of Prinzmetal’s angina.
What is phentolamine? What is its clinical significance?
It is a reversible α1 and α2 antagonist. It is given to patients on MAOIs that eat tyramine-containing foods.
What is the prodromal presentation of hepatitis B infection? What are the acute lab findings?
Serum sickness-like: Malaise, fever, LA, headache, rash, pruritus, arthralgia. Acute labs: elevated ALT, AST, bilirubin, alk phos
What are 4 signs of a villous polyp?
- Occult blood; 2. partial obstruction; 3. mucus secretion; 4. progression to adenoca.
What 3 bugs are common causes of pneumonia 2ndary to influenza A infection?
Staph aureus, s. pneumo, h flu
What is the MOA of opioids?
Open K channels, close Ca channels
What is the MOA of streptokinase?
Forms a complex w/ plasminogen to cleave and activate plasmin. Plasmin cleaves fibrin. The complex also destroys fibrinogen, CF V and VII.
What are the side fx of inhaled anesthetics? What drug is associated with each?
Hepatotoxicity (halothane); nephrotoxicity (methoxyflurane); convulsions (enflurane); expansion of trapped gas (nitrous oxide); malignant hyperthermia (all)
What is the treatment for Lyme’s disease?
Doxycycline and ceftriaxone
How is Lyme’s disease diagnosed?
AB detection (ELISA or Western blot) or culture by Wright-Giemsa stain.
What are the clinical features of lead poisoning (6)?
Abdominal colic, constipation, headache, blue pigmentation at tooth-gum line, microcytic microchromic anemia w/ basophilic stippling, peripheral neuropathy.
What are the s/s of adrenal crisis (3)?
Hypoglycemia, tachycardia, hypotension
What information does the VPL relay?
It relays information from the dorsal and spinothalamic tracts to the primary somatosensory cortex.
What are the s/s of chronic adrenal insufficiency (4)?
Vomiting, weight loss, abdominal pain, hyperpigmentation.
How do arterial vasodilators cause increased sympathetic activity? What drugs are arterial vasodilators?
The decrease in arterial pressure induces baroreceptor-mediated sympathetic firing causing increased contractility, heart rate, and renal activity. Hydralazine and minoxidil.
Describe the negative feedback mechanisms of the GnRH axis
FSH stimulates granulosa cells and sertoli cells to secrete inhibin A, which inhibits FSH. LH stimulates theca cells and leydig cells to secrete testosterone, which inhibits GnRH and LH.
What are the common causes of meningitis in neonates (0-6mos)?
GBS, E. coli, Listeria
What are the common causes of meningitis in kids 6mos - 6yrs
S. pneumo, H. flu B, N. meningitidis, enterovirus
What are the common causes of meningitis in people 6yrs-60yrs?
S. pneumo, N. meningitidis, enteroviruses, HSV
What are the common causes of meningitis in people over 60 years?
S. pneumo, gram (-) rods, listeria
What are the common causes of pneumonia in neonates 0-4wks?
Group B strep, E. coli
What are the common causes of pneumonia in kids 4wks-18yrs?
RSV, mycoplasma, C. trachomatis, S. pneumo
What are the common causes of pneumonia in adults 18 yrs-40yrs?
Mycoplasma, C. pneumophilia, s. pneumo
What are the common causes of pneumonia in adults 40-65 yrs?
S. pneumo, H. flu, anaerobes, viruses, mycoplasma
What are the common causes pneumonia in elderly older than 65?
S. pneumo, H. flu, influenza, anaerobes, gram (-) rods.
List the steps of B cell differentiation.
1) Precursors mature and prolif in the bone marrow
2) Mature B cells migrate into lymphoid organs
3) Exposure of Ag induces activation of a clone of B cells (differentiation into plasma cells secrete IgM, a majority migrate to the lymphoid follicle)
4. The germinal ctr is the site of B cell prolif.
5. The germinal ctr is the site of isotype switching via CD40-CD40L interactions
What medications are used to induce abortion within the first 49 days of pregnancy?
Mifepristone: a competitive progesterone antagonist
Misoprostol: a PGE1 analog that causes uterine contraction and cervical dilation
What is the morphology of Buerger’s disease? What arteries are most commonly affected?
AKA thromboangiitis obliterans. Acute and chronic inflammation w/ thrombosis of the lumen extending into contiguous veins and nerves. Tibial and radial aa. are most commonly affected.
How does carboxyhemoglobin alter O2-carrying capacity?
Decreased O2 binding and a left shift in the O2-dissociation curve.
What is pure red cell aplasia? With what conditions is it associated?
It is destruction of erythropoieitic precursors by IgG autoABs and CTLs. It is associated with thymomas and lymphocytic leukemia.
What are the naked viruses?
Calicivirus (norwalk virus), picornavirus (polio, echo, rhino, coxsackie, HAV), reovirus (rotavirus); parvovirus, adenovirus, papillomavirus, polyoma virus (JC and BK)
What is the presentation of ornithine transcarbamoylase deficiency?
Elevated NH4+, neuro disorders, increased excretion of orotic acid. Carbamoyl PO4 is converted to orotic acid for use in the pyrimidine synthesis pathway.
What is pentazocine?
It is an opioid narcotic w/ partial agonist activity and weak antagonistic activity at µ receptors. It decreases analgesic effects and induces withdrawal symptoms in people dependent on morphine.
What are the features of intravascular hemolytic anemia? What are some examples of intravascular hemolysis?
Elevated LDH, decreased haptoglobin, hemoglobinuria. Paroxysmal nocturnal hemoglobinuria and prosthetic valves.
What are the features of extravascular hemolytic anemia? What are some examples of extravascular hemolysis?
Macs clear RBCs in the spleen. Elevated LDH, elevated UCB, jaundice. G6PDH deficiency, sickle cell, spherocytosis.
In what conditions are Cheyne-Stokes respirations seen?
CHF, stroke, brain tumor, traumatic brain injury.
