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51 Cards in this Set
- Front
- Back
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Idiopathic thrombocytopenia Purpura
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purpura, mucosal bleeding, decreased platelets, self limited and ost-viral in kids, adults anti-platelet antibodies, chjronic tx is steroids
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Patient with severe thrombocytopenia, shistiocytes and helmet cells, low Hb, high retic count, fever, high LDH. Dx and Tx
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TTP, Tx is plamapheresis otherwise fatal
high LDH d/t lactate activity elevated by ischemic organ damage |
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what precipitates probs in G6PD?
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things that cause increased ROS, fava beans, sulfa drugs, quininess
XLR, RBC lysis lack enzyme for NADPH synthesis |
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Inheritance pattern and substitution in sickle cell anemia
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AR, valine for glutamate at 6th aa on beta globin chain
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Direct vs. indirect Coombs test
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Direct looks for antibodies bound to RBCs in blood in immune mediated hemolysis
Indirect looks for free floating antibodies in blood (Rh- females in pregnancy) |
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B-thalasemmia presentation
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Minor- microcytic anemia, jaundice, leg ulcers, splenomegaly
Major- severe microcytic anemia, two mutated B alleles not A-thalasemmia 4 total allels 2/parent |
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Patient ate some bad fish, now megaloblastic anemia. causative organism?
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Diphyllobothrum latum - causes B12 deficiency
leukopenia, hyersegmented neutrophils, thrombocytopenia |
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Plummer-Vinson syndrome caused by...
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low grade long-term iron deificency, causes esophageal web (structural defect)
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Fanconi anemia
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unable to remove oxygen radicals from bone marrow, AR, HIGH RISK FOR LEUKEMIA, recurrent aplastic anemia, absent radius bones, small thumbs, microcephally
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Significance of Heinz odies, Howell-Jolly bodies, basophillic stippling
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Heinz- G6PD, denatured Hb in RBCs
Howell-Jolly- nuclear fragments, immature RBCs basophilic stippling- lead poison |
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Causes of neutropenia
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Decreased production- BMD, chemo, HIV infection, B12/folate
increased destruction- Felty syndrome (autoimmune destruction) |
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Which baterial infection causes elevated lymphocytes?
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Pertussis, kills cells in resp tract
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Leukemias
1. Most common in children 2. Auer rods 3. Philadelphia Chromosome 9:22 bcr-abl fusion |
1. ALL- immature lymphocytes
2. AML (immature other cell types) 3. CML- mature cells, low leukocyte alk phos |
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Hodgkin's vs. Non-Hodgkins lymphoma
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Hodgkins- lymphocyte rich, nodular sclerosing, mixed, lymphocyte depleted, RS cells, nodal involvment contiguous spread
Non-H- widespread adenopathy, associated with viral, bcl-2, spreads to multiple nodes both have neutrocytosis d/t inflammaiton |
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MOA and major side effect of the azole drugs
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interact with fungal p450, block demethylationof ergosterol can't make cell membrane
hepatotoxicity |
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DOC for most fungal infections:
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Flucanozole, vaginal candiasis - miconazole
Itraconozole is more broad sectrum and more potent but more toxic |
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DOC for aspergillosis
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voricanozole, can have visual changes in addition to liver tox
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Amphotericin B
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binds ergosterol, leading to pore formation allowing electrolyte imbalances, nephrotoxic
nystatin- similar mech, used for thrush |
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Griseosulvin MOA, use and tox
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intreacts with miucrtubules revents eukaryotic cell division, accumulates in skin and nailes ued for skin infections,
heatotixc, teratogenic, disulfarim rxn, induces 450 |
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DOC for fungal nail infections/MOA
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terbinafine- inhibits squalene epoxidase needed for synthesis of ergosterol, can cause hepatitis (used topically)
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what two species of plasmodium require primaquine tx in addition to standard tx and why?
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ovale and vivax- hypnozoite forms remain latent in liver and not killed by standard tx
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DOC for chlorquine-sensitive species of plasmodium and pregos
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chloroquine- kills drugs bt inhibiting their DNA synthesis, transmformation of heme into a toxin, forms comlexes that lyse it and RBCs contianing it
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DOC for P. falciparum
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quinine plus doxy, tetracycine or clindamycin
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Metronidazole
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DOC for tichomnasis and amoebiasis, acts as an electron acceptor, causes binidn gof protiens to DNA causing death,
Tinidazole- same mech, less side effects, DOC for giardia |
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Drug for treatment of trypansoma cruzi
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nifurtimox, creastes ROS destroys enzymes killing organism
abd pain, NV |
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tetanus toxin vs. botulinum toxin
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tetanus- blocks glycine release leads to disinhibition and spasm
botulinum- inhibts release of ACh leads to parlysis |
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Diphtheria toxin
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inhibits protein synthesis
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Obligate aerobes vs. obligate anaerobes
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aerobes- TB, pseudomonas, nocardia, require O2
anaerobes- clostridium, actinomyces, ferment and killed by O2 most of the rest are facultative anearobes |
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Most common cause of pneumonia in infants, young adults and elderly
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infants- RSV
young adults- mycoplasma elderly- strep pneumonia |
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Most common causes of diarrhea in kids, adults, travelers
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kids- rotavirus
adults- campylobacter traveler's- E coli, Shigella, salmonella |
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Most common causes of bacterial menigitis in neonates, adults, elderly
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neonates- E coli, strep agalctia, listeria
Adults- neiuserria Elderly strep pneumo |
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gram + cocci in clusters, catalase and coagulase (huge for this one) positive, what exotoxins?
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staph
enterotxins - darrhea toxic shock syndrome toxin- anaphylaxis exfolaitin- scalded skin alhpa toxin - tissue necrosis |
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Patient with acute sore throat, malaise, fever of 39-40 C, yellow exudates... bacterial =
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strep pyogenes
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B-hemolysis vs, alpha vs. gamma
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B- complete hemolysis, clear, pyogenes, most others
a- incomplete- green halo, pneumocccu, viridans gamma- no hemolysis, enterococci |
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bean shaed gram - diplococci, fements maltose has capsule on CSF gram stain
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Neiserria Menigitidis
Waterhouse-Fiderichsen syndrome- adrenal failure d/t hemorrhage of glands in septic patients, causes much badness Tx is pcn |
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Male has dysuria and urulent discharge, gram stain is gram neg diplococci bean shaped =
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neiserria gonorrhea treat with ceftriaxone, can cause purulent arthritis
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corynebacterium diphteheria
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pseudomembranes, Chinese characters
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Bacillus anthracus
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gram + bacillus, anthrax, woolsorter's dz
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Clostridium erfingens
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spore forming rod, anearobe
a-toxin causes gas gangrene entertoxin causes food poisoning |
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Patient has nausea vomiting and abd cramps then develos dry mouth, diplopa, loss of pupil reflex, does home canning. Thoughts?
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C. botulinum, will rogress to descending parlysis adn resp failure
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Facultative anearobe, gram neg rod, most common cause of UTI
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E coli
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Shigella
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non-motile gram neg lactose negative, causeswatery diarrhea followed by fever, bloody stools and cramping
attacks and invades GI epithelium |
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E coli vs. salmonella vs. shigella
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e coli- motile and lactose +
salmonella - motile, lactose - Shigella- non-motile lactose neg |
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Patient has UTI develops ammonium calculus
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proteus, motile produces urease leading to ammonium calculi
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treatment for H. pylori
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metronidazole, tetracylcine and bismuth
associated with MALT lymphoma |
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Comma shaped gram neg, rice-watery diarrhea. Toxin and tx
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vibrio cholera
hydration, tetracyline toxin ribislyates Gs protein causing permanent activation of adenylate cyclase causing secretory diarrhea |
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Exposure to rodents, large tender lymph nodes...
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yersinea pestis, bubonic plaque from fleas tx is streptomycin and tetracycline
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Patient has lesion expanding macule with central clearing then gets fluctuating mengiitis, facial palsy peripheral neuropathy
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lyme disease from tick, tx is docycycline
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Tx for all chlamydias from pneumonia to trachomatois (coitus) to psitcci (bird poop)
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tetracycline
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Life cycle of chlamydia
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elemnary bodies are infected then transforms into reticulocyte body for cell division (initial body) then back to elementary body and rupturing of cell
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Patient has fever, headahce, conjunctival redness, trash on wrist and later trunk, went hiking...
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R. ricjetsiea from ticks
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