Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
76 Cards in this Set
- Front
- Back
|
Findings in multiple myeloma
|
osteolytic lesions- d/t IL-6 and IL-1 activate osteoclasts
M-spike- elevated monclonal protein anemia, leukocytopenia, hypercalcemia, Bence-Jones protein |
|
|
Waldenstrom;s macroglobulinemia
|
plasma cell neoplasms w/ flame cells leads to hyperviscosity syndrome, overproduction of IgM
fatigue, weakness,, skin and mucosal bleeding, headache, vision probs |
|
|
Virchow's Triad
|
1. stasis
2. hypercoagulability 3. endothelial cell damage |
|
|
Pathophysiology of atherosclerosis
|
LDL cholesterol depositon on intima leads to accumulation of foam cells and infallammatory mediators causing plaques
leads to decreased lumen,vessel wall weakening |
|
|
Hyaline vs. hyperplastic arteriolosclerosis
|
Hyperplastic- malignant HTN, affect small arteries, onion skin hyperplasia
Hyaline- inflammation and use, thickening of BM, narrowing lumen, diabetes, HTN and age, nephrosclerosis when associated with kidney |
|
|
Small vs. medium vs. large vessel vasculitis
|
small- skin, muscles, brain and kidney, purpura, glomerulonephritis. Wegener's HS, hyersensitivity arteritis.Churg strauss, microscopic polyangitis
medium- polyarteritis nodosa, Kawasaki, thrombangitis obliterans large- claudication, weakened pulses, Giant cell, takayasu |
|
|
Patient with hepatitis, presents with abd pain, fever, melena, renal disease and HTN... d/t
|
polyarteritis nodosa= transmural necrotizing inflammation ofvessels, seen with HBV, HCV and hiary cell leukemia
|
|
|
Microscopic polyangiitis vs. HSP
|
HSP d/t IgA immune complexes seen primarily in kids, variant of hypersensitivity in kids
Micrscopic polyangiitis= pANCA positive, reaction to drugs, causes severe GN, RPGN, and pulmonary cappilaritis, hemotypsis, hematuraa |
|
|
Hypersensitivity reaction to tobacco, causes blood vessel destruction
|
Thrombangiitis obliterans, leads to severe pain in distal limb, progresses to gangrene, granulomas in vessel walls
|
|
|
Giant cell arteritis
|
granulomatous inflammation of vessel walls, tetrad of fevere, fatigue, hi ESR, may cause sudden monoocular blindness
polymyalgia rhematica- systemic manifesation of same disease, very high ESR, limb claudication |
|
|
Asian female presents with night sweats, CP, and weak/absent peripheral pulse, dx?
|
Takayasu arteritis, thickening of aortic arch with huge granulomas, eventual organ ischemia
|
|
|
Churg Strauss
|
granulomas, massive eosinophil invasion in vessel wall, + p-ANCA, affects vessels in skin, nerves, muscel, LUNG and Heart, asythma lie attacks with lung infiltrates, coronary vessel construction
|
|
|
Behcets syndrome
|
vasculitis of veins, paingul oral and genital ulcerations, may lead to brain and GI damage
anti human oral mucosa antibodies |
|
|
Luteic aneruysm
|
Seen in tertiary syphilis, obliuterative endarteritis oif the vasa cvasorum of the aorta, causes ischemia and atrophy of medial leading to buckleing and treebarking appearance of intima, may cuase aorttic regurge
|
|
|
Presentation of aortic arch aneurysm
|
1. dyspnea, compression of resp structures
2. persistent cough- compression of recurrent laryngeal 3. heart failure if aneurysm caused aortic regurge 4. rupture and death |
|
|
Aortic dissection
|
split between laminar planes of media, collection of blood within the aortic wall, can rupture to cause massive hemorrhage or if dissects to arterial branches leads to occlusion and ischemia
|
|
|
Azole drugs
|
interact with fungal p450 blocking demthylation needed for ergosterol
All are hepatotoxic Fluconazole- thrush, non-systemic coccidioomycosism, cryptococul Mcanozole- vaginal candiasis Itraconazole- most potent, but most toxic, used for black molds voriconazole- aspergilosis |
|
|
Use and tox for Amp B
|
Nephrotoxic- RTA and hypokalemia ARF
Tx for crytococcal meningitis, w/ flucytosine, rhizopus, fusarioses |
|
|
Drug inhibits squalene epxodase to inhibit ergosterol sythesis
|
terbinifine- DOC for nail infections and tinea capitis, can cause severe hepatitis
|
|
|
what;s special about P. ovale and vivax? Falciparum?
|
Ovale and vivax have hypnozooite stage that requires tx with primaquine to clear from liver
Falciparum is chloroquine resistant, seen a lot in Africa and middle east |
|
|
Prophylaxis for malaria? In pregos? In chloroquine resistant areas?
|
Chloquine - for pregos, mefloquine (mahor side effects, crazy peops)in resistant areas
Atovaquone-proguanil in resistant areas, inihibts electron transport chain Doxycycline also works |
|
|
DOC for chloroquine resistant P vivax?
|
quine plus doxy or tetracycline + primaquine, equally effective alternative is mefloquine plus primaquine, pregos have to wait til after babe
|
|
|
Major side effect with quinine?
|
Cinchoism- tiniitus, depression, confusion , headache, nausea, photophobia
inhibits DNA synthesis DOC for palasmodium falciparum + doxy, or tetra, or clindamycin |
|
|
Metronidazole MOA, DOC and adverse
|
electron acceptor -> compunds tha bind proteins and DNA
Used for amoebiasis, trichominasis alt to tinidazole in giardia disulfarim, seizures, peripheral neuropathy |
|
|
Ntiazoxinide
|
DOC for crytosporidiosis, inhibits electron transport mechnisms
|
|
|
DOC for pneumocystis jirovecii
|
TMP-SMX also toxoplasma
act on folate portion of DNA synthesis |
|
|
Parziquwntil is used for treatment of all...
|
flatworms, increases cell memrbane permeability to calcium causing tetany
|
|
|
Albenzandazole and mebendazole
|
used for round worm infections, bind to tubulin to prevent micrtubule formation, teratogenic, used for trichinosis
|
|
|
Ivermectin
|
DOC for stronhylodies, opens voltage gated chloride channels found only in helminths causing flaccid aralysis
|
|
|
Drugs used for ectoparasites
|
permethrin- DOC for scabies and both kinds of lice, inhibits transmission of nerve impulses leading to permanent paralysis
Malathion |
|
|
HIV drugs
1. nucleosides 2. NNRTIs 3. Protease inhibitors 4. Fusion inhbitors 5. Integrase inhibitors |
1. diadnosisine, lamivudine, zidovudine, tneofovir
2. efarvirenz, nevirapine 3. Ritonaxir, atazanavir, indinavir 4. enfuvritide 5. raltegravir |
|
|
What isa CCR5 antagonist? what does it treat?
|
Blocks corectro of CCR5 on WBCs targeted by HIV, maraviroc
hepatotoxic, increased risk of infections |
|
|
Patient has HIV and is CD4 under 350, or HIV associated nephropathy, or current hepatitis or pregnant. What drug regimen options?
|
2 NRTIs + 1 protease inhibitor or 1 integrase inhitor or 1 CCR5
started in all pregos regardless of CD4 count, lopinavir + zidovudine + lamivudine |
|
|
Tx for cryptococcal emeningitis in HIV patient
|
Amp B + flucytosine followed by flucanozole for 8 weeks
may prophylax with fluconazole for CD4 < 50 |
|
|
Alternatives to TMP/SMX for toxoplasa, penocystis in HIV patients
|
dapsone prohpylaxis or dapsone,, prymtheramin and leucovorin
|
|
|
Translation inhibitors
|
50s- chloramphenicol, erythromycin (macrolides), clindamycin
30s- amingoclycosides (bactericidal), tetracycline |
|
|
Aminoglycosides MOA and tox
|
only works for aerobes needs O2 to cross membrane, blocks initial steps in protein synthesis causes misreading of mRNA
ototoxic, nephrotoxic and neurotoxic (don't cross BBB) |
|
|
Chloramphenicol vs. eryhromycin vs. clindamycin MOA
|
Chloramphenicol binds to 50S subunit blocks action of peptidyl transferase, very toxic, BMD
Eryhromycin- block translocation of aa's during peptide ond formation, DOC for mycoplasma, prolong QT Clindamycin- same as chloramphenicol, anaerobic infections above the diaphragm |
|
|
Anti-folate drugs
|
pyrimethani, trimetoprin, sulf antibiotics, dapsone
all inhibit ruine and pyrimidine syntheiss via folate, can cause megaloblastic anemia |
|
|
Used for tx of ALL, inhibits denovo urine syhteisis
|
6-mercaptopurine causes BMD and hepatotoxicity
|
|
|
Pryrimidine analogs
|
5-fluroruracil
Cytarabine- Non-lumpohocytic leukemia, usual chemo stufff + fever, malaise, myalgia, nbone pain, conjunctivitis, rash, CP Flurouracil- inhibits thymidine synthesis, used for slow growing solid tumors, breast, colorectal and gastric tumors |
|
|
Fluuroquinolones
|
-floxican, inhibit DNA gyrase, cause QT prolongation, works well against both Gram neg and Posative, not for under 16 d/t joint cartilage injury
|
|
|
Dactinomycin, doxorubicin, belomycin MOA and tox
|
Dactinomycin- interferes with DNA dependany RNA polymerase, can cause tissue necorsis
Doxorubicin- creates ROS that causes DNA breaks, BMD< cardioopathy leading to HF and tissue necrosis Blemomycin- binds DNA, forms ROS, nephrotoxic, hepatotic, lung fibrosis |
|
|
Rifampin
|
used in Tb, transcription inhbitor, hepatotoxicity, BMD, also works for prophylacis of meningoccous and H flu meningitis
|
|
|
Herniated disc affects nerve roots at level... also where does the spinal cord end
|
Affects nerve root at level below, I.e. L4 disc compresses L5 nerve
Spinal cord ends at L1-2, lumbar incture on cauda equina |
|
|
Ferguson's angle and significance
|
intersection line of inclination of the sacrum with horizontal line in same plane as ASIS
increased angle increases stress on lumbosacral joint -> back pain normal is 25-35 |
|
|
The primary motion of the lumbar spine is...
|
felxion and extension
flexion/extension > SB > rotation |
|
|
Cauda equina syndrome
|
can be d/t massive central disc herniation resulting in nerve root compression, has saddle anesthesia and urinary/fecal incontinence
|
|
|
spondylolisthesis vs. spondylolysis
|
lithesis- anterior deplacement, graded in 25% increments of slippage
lolysis- fracture of vertebra, scotty dog fracture |
|
|
5 classifications of spondylolisthesis
|
type I- dysplastic congential defect of L5
type II- most common, pathology of pars interarticularis type II- degenertive- most commonly L4, degeration of zygopophysela joints Type IV- traumatic Type V- pathologic- d/t paget's, OI, cancer |
|
|
Most common congenital anomaly in lumbar regon?
|
zygopophyseal tropism (asymmetry of joint)
second most is sacralization |
|
|
Important lumbar landmarks
|
L4-5 iliac crests
imbilicus- L3-4 segments |
|
|
List DNA viruses
|
parvoviruses, papillomaviruses, adenoviruses, ox viruses, HBV
|
|
|
Herpes viruses all have something in common what is it?
|
all double stranded DNA, all remain latent in host cells and can be reactivated when immunocompromised
EBV- B - cells leads to carcinomas and lymphomas |
|
|
RNA viruses
|
rhino, echo, coxsackie, Hep A, olio, rotavirus, influenza, runeaola, parainfluenza, mumps, RSV, rubella, arbovirus
|
|
|
Coxsackie A causes
Parainfluenza causes |
hand foot and mouth disease
croup |
|
|
Patient has a respiratory tract infection, lives in southwest, exposed to mice... thoughts?
|
Hantavirus, can get pretty sick
other arboviruses d/t mosquito vectors most causing encephalitis |
|
|
transmission of prion diseases?
|
transmitted to other specieds by inoculation of infected brain tissue
Kuru, Creutzfelt-Jakob, BSE (mad cow) |
|
|
What single stranded RNA virus is associated with adult T cell leukemia? How does it cause it?
|
HTLV-1, activates c-onc protoncogenes leading to malignant transformation
|
|
|
Important markers for HIV
1. gp41 2. Gp120 3. p24 |
1. mediates cell fusion- enfuviritde
2. binds to CD4 recetor, rapidly mutates, maraviroc 3. serum marker ELISA is ensitive for screening Western blot is very specific |
|
|
Fungi found as molds (form hyphae), dimorphic, yeasts (single cells)
|
molds- aspergilus
yeasts- candida, crytptococcus dimorphic- histomasma, blastomyces, coccidiodes |
|
|
Significance of spores and conidia?
|
Spores are sexual reproduction requiring 2 cells to fuse
conidia- asexual reproduction |
|
|
Histoplasmosis vs. aspergillosis vs, coccidiodomycoses
|
histolasmosis- yeast in macs, Mississippi valley asymtomatic to progressive pulmonary disease like Tb
Coccidiodomycoses- valley fever, cough, arthralgia, Southwest, endospores in tissue Aspergillosis- allergy, excarebates asthma, radiologically visible fungus ball in lungs in immunocomrpomised, V shaped |
|
|
Life cycle of malaria
|
sporozoits enter blood, turn into merozoites (if latent hypnozooites), released from liver to infect RBCs, trophozoites mature and form multinulceated shizonts, release 10-20 new merozoites or gametocytes
|
|
|
Fever peaks every 72 hours in malaria why?
|
sporozoites reproduce asexually in RBCs, eventually burst causing periodic fever and anemia
|
|
|
Treatment for sleeping sickness
|
trypanasoma gambense is less severe than rhodensiense
tx is suramin, melarsoprol |
|
|
Entomoabea vs. giardia vs. crytosporidium
|
Entoamboeba- metronidazole, bloody diarrhea, liver abcess, 1 nucleus ingests RBCs
Giardia- flagellated multiple nuceli, foul smelling diarrhea, tinidazole or metronidzole Crytpo- severe dirarrhe in AIDs, no effective therapy |
|
|
Female with foul-smelling watery, green discharge from vag. Organism and tx
|
trichomonas, metronidazole
common STD |
|
|
Schistoma
|
blood flukes, penetrate skin and enter through small veins assing through lungs and heart into systemic circulation, settle in portal vein until sexual maturity
tx is praziquental |
|
|
Tapeworms!
|
Solium- larvae in pork, Saginata larva in beef, both settle in intestine
solium in human poo egg form can get to brain and eyes... tuh oh... |
|
|
Box like segments in tapeworkms called...
|
proglottids
|
|
|
Roundworms that migrate to lungs?
|
Strongyloides, ascaris
tretmnet are mebendazole and pyrantel pamoate |
|
|
Processes taking place in the mitochondria
|
Krebs, fatty acid oxidation, formation of Acetly CoA,
part of urea cycle, gluconeogensis and heme synthesis (rest occurs in cytosol) |
|
|
Vmax and Km
|
V max- maximal rate of reaction when enzyme is saturated
Km- substarte concentration at which rexn rate is half of its maximal value competive inhitors alter vmax and Km noncomeptitive- maintain Km, alter Vmax |
|
|
AAs that are gluconeogenic or ketogenic
|
isoleucine, threonine, tryptophan, pehnylalanine
strictly ketogenic- lecine and lysine (can be made into acetyl CoA) |
|
|
Important precurors
1. tyrosine 2. trytophan 3. glutamate 4. glycine 5. histidine |
1. catecholamines, melanin, thyroxin
2. serotoin, mealtonin, niacin 3. GABA 4. heme, creatinine 5. histamine |
