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91 Cards in this Set
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What is Ghons complex and what does it invlove?
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Lobar (usually lower) and perinodal hilar involvement. Reflects primary TB infection
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Potts disease?
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TB spread via lymph nodes to vertebral bodies
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Hansens disease?
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Leprosy... either lepromatous (diffuse skin lesions) or tuberculoid (few hypoesthetic lesions)
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Waterhouse Friderichsen disease?
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caused by Neisseria menigitidis causing massive hemorrhage of adrenal glands. Sx = shock, DIC, widespread purpura, adrenal insufficiency
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What bug causes HUS and what is it?
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enterohemorrhagic E.coli..... triad of anemia, thrombocytopenia, and acute renal failure.
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Tell me about Lyme disease... Sx, causitive agent, tx...etc
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Cause Borrelia burgdorferi
mice/ deer resovoirs Stage 1 = erythema migrans, flu sx Stage 2 = neurologic (bells palsy) and cardiac (av node block) Stage 3 = migratory poyarthritis tx= doxy ,cephlasporin |
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primary vs secondary vs tertiary vs congenital syphilis
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1= painless chancre on dick
2= systemic (maculopapular rash, condylomata lata 3= gummas, aortitis, neurosyphyllis, Argyll Robertson pupil (accomodation but doesnt react to light) congenital = mulberry molars, hutchinson teeth, Sabers shins, saddle nose, CN 8 deafness |
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Weil Felix reaction
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test for Rickettsia
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Life cycle of the CLAP (chlamydia)?
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Elementary bodies infect and enter the cell. They form into Reticulate bodies that replicate inside the cell and then release more Elementary bodies.
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What does dimorpic mean and what are the dimorphic fungi?
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2 forms exist one in the environment and one in the body. COLD=MOLD, HEAT= YEAST.
Histoplasmosis - Miss/Ohio hide in Mphage Blastomycosis= Miss/Central america Broad base budding Coccidiodomycoses= SW US (spherule in tissue not yeast) Paracoccidioies = latin america "captians wheel formation" |
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1. Candida
2. Aspergillus 3. Cryptococcus 4. Mucor |
1. Pseudohyphae
2. 45 branching septate hyphae 3. yeast with halo capsule 4. nonseptate hyphae wide branching |
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Grandma was picking flowers in the garden and complained about getting pricked by rose thorns. A day later she develops a pustule on her finger with ulcerating nodules on her arm all the way up to her supraclavicular nodes. Disease? Causitive organism?
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Rose Gardners Disease
Sporothrix schenkii |
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Case 1... Nigglets swimming in a stream.... week or two later they develop- what caused it?
Case 2. Dude swimming in lake Tahoe... dies rapidly of menincoencephalitis. what does he have? |
1= Giardia
2 = Naegleria (Nalgene full of freshwater) |
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Dude on hiking trip in Smokey Mnts comes down with a fever. Goes to the doc and he says that he has developed hemolytic anemia and see maltese cross formations on blood smear. what did he get
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Babesiosis from tick bite
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Go to Africa and see tribal people with swelling around the eye, blindness, and hyperpigmented skin,(how u see this on blacks I dont know) Mc cause?
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River blindness from black flies
Onchocerca volvulus |
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Cystercosis and undercooked pork =
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Taenia solium
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Lived attenuated vaccines are..... Killed.....?
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Live attenuated = yellow fever, smallpox, chickenpox, Sabins polio, MMR
Killed= Rabies, Influenza, Polio, HAV (RIP) |
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Naked viruses (no envolope) are....
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CPR and PAPP
Calcicivrus, Picornovirus, Reovirus, Parvovirus, Adenovirus, Papilloma, Polyoma |
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Herpes Family 1-8??
Hint: Got Herpes riding dirty in a CHEV |
1= oral
2= genital 3(VZV)= chicken pox, shingles 4(EBV)= mono, Burkitts 5(CMV)= immunocompromised, babies, and transplants 6= roseola 7= Cx insignificant 8= Karposi's sarcoma |
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Sick baby, fluid in lungs, infected cells have owl eye appearance?
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CMV
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Baby Seal bark cough?
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Croup.... Paromyxovirus (parainfluenza)
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Cureous George's owner The man with the Yellow Hat has a high fever, vomits black, and his skin color matches his hat color. Councilman bodies are found at autopsy. Im curious to what he died of?
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Yellow Fever
Flavivirus |
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Kid come sin with red spots with blue/white centers on buccal mucosa, couch,coriza, conjunctivitis. Path report reveals Koplik spots
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Rubeola (measles)
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Chronic hepititis, cirrhosis, and hepatocellular carcinoma are in volved in what to Hep viruses?
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HBV & HCV
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ALT>AST is from what form of hepatitis?
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Viral..... (alcoholic is opposite)
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Mutation in what gene provides immunity with HIV?
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CCR5 (homozygous =immunity)
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Gay Negro comes in with candidal esophogitis, toxoplasmosis, and histoplasmosis.... What is his most likely CD4 count?
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100
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Everyone gets sick after an oyster roast... MC agent?
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Vibrio parahaemolyticus or vulnificans
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Bloody Diarrhea organisms? 8
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Campylobacter, Salmonella, Shigella, Enterohemorrhagic E.coli, Enteroinvasive Ecoli, Yersinia enterocolitica, C. difficile, Entamoeba histolytica
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MC cause of osteomyelitis?
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Staph aureus
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Baby with PDA, cataracts, deafness, and blueberry muffin rash?
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Rubella
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Kid with lymphadenopathy, arthritis, and develops a rash that starts at the head and spreads down?
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Rubella
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Big slut come in wiht cervical motion tenderness and purulent cervical discharge. DDX for 2 MC bugs that cause this?
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Pelvic Inflammatory Disease..... Chlamydia trachomatis and Neiserria ghonorrhea
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AIDS patient with cotton wool spots on funduscopic exam?
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CMV (also causes interstitial pneumonia in AIDS...see intranuclear/cytoplasmic inclusion bodies)
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Patient was wakeboarding and fell having severleft flank pain. Surgeon was called in to do a splenectomy. When everythin heals the patient is informed that he will be at a higher risk for certain bacteria such as......
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SHiN (encapsulated---- S.pneumo, H.influenza B, N. meningitis)
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Need a bactericidal drug for a serious infection... you would pick what?
1. Erythromycin 2. Chepalosporin 3. Clindamycin 4. Chloramphenicol 5. Sulfa and Trimethroprim |
Cephalosporin
( others would include Vanc, Fluroquinolones, Penicillin, Aminoglycoside, Metronidazole) Very Finely Proficient At Cell Murder |
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Amp and Amoxicillin are extended spectrum penicillins used to combat what specific bacteria? Hint= HELPS
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H.influenza
E.coli Listeria Proteus Salmonella |
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Cefoxtitin, Cefaclor, Cefuroxime are useful in what infections and what generation are they? Hint= HEN PEcK
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2nd generation
H. influenza, Enterobacter, Neiserria, Proteus, Ecoli, Klebsiella |
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Get a ABX and develop "red man syndrome" What drug is it and what are the SX?
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Vancomycin
Nephrotoxicity, Ototoxicity, and Thrombophlebitis |
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Baby develops meningitis at 6 mos.... MC cause of it? What drug do you give? and possible SE?
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Strep Pneumo
Chloramphenicol Grey Baby syndrome |
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If one has a sulfa allergy what drugs should they not get?
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anything that starts with sulfa, thiazide diuretics, acetozolamide, furosemide
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You get prescribed Metronidazole for diarrhea. What caused it?
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Could be Giardia, Entamoeba, or Clostridium.
Also gets Gardnerella, Trichomonas, Bacteroides |
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What do you use prophylactically for Gonorrhea?
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Ceftriaxone
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A patient is taking an antifungal and develops nephrotoxicity,arrythmias, anemia, and IV phlebitis. He is also hypotensive with chills. What did he take?
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Amp B
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Tx for invasive aspergillosis?
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Caspofungin
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Patient takes Ribavirin. What did they probably have? What are possible side effects?
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RSV, chronic Hep C
Hemolytic anemia, teratogen |
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AIDs drugs... tell what category each goes into.
Zidovudine Nevirapine Ritonavir Enfuvirtide |
Reverse trasncriptase inhibitors (non nucleoside)
"" nucleoside Protease inhibitor Fusion inhibitor |
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ABX to avoid in pregnancy?
Hint: SAFE Moms Take Really Good Care |
Sulfa- kernicturus
Aminoglycoside-ototoxicity Fluoroqinolones- Cartilage damage Erythromyocin - acute cholestatic hepatitis in mom Metronidazole - mutagenesis Tetracyclin- teeth, bones Ribavirin- teratogenic Grisefulvin- teratogenic Chloramphenicol- grey baby |
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The superficial inguinal node take drainage from what parts of the body?
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Anus below the pectinate line, scrotum, testes(as well as the deep), thigh.
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Patient with splenecomy gets an infection. What is it most likely from and what are lab findings post splenectomy?
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Encapsulated bacteria (SHiNS)
Strep. pneumo H.influenza Neisseria Salmonella See Howell Jolly bodies, Target cells, and thrombocytosis |
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B 27 HLA subtype is associated with what diseases? Hint: PAIR
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Psoriasis Ankylosing spondylitis, IBS, Reiters syndrome
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Delayed cellmediated hypersemsitivity is involved with T or Bcells?
Hyperacute organ rejection? |
Tcells
Bcells |
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Cytotoxic T cell activation?
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Signal 1= antigens are presented on MHC1
Signal 2= Il-2 from Th cell activates to kill antigen |
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Tell me about the Fc region of the antibody?
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constant, complement binding (igG &M), determines isotype
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The most abundant antibody, delayed response, and crosses the placenta is....
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IgG
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What does Il-4 do?
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Stimulate switching to IgE and IgG
* Hot T Bone stEAk |
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Deficiency in DAF will lead to what?
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complement mediated lysis of RBC's and paroxysmal nocturnal hemoglobinuria.
DAF blocks C3 convertase on self cells |
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Name 4 granulomatous diseases.
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TB, histoplasmosis, syphilis, leprosy, Cat scratch fever, Sarcoidosis, Chrons, Berrylliosis
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Transplant rejections and TB tests are what type of hypersensitivity?
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Type 4
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Patient has a polyarteritis nodosum (small vessel vasculitis i.e. palpable purpura) what type of hypersensitivity is it?
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Type 3
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Matching
Anti IgG, Anti Jo-1, Anti Ro/La (ss-A/B), Anti ANA, Anti basement membrane SLE, Goodpasteurs, Sjorgens, polymyositis/dermatomyositis, RA |
Anti IgG= RA
Anti Jo-1 = poly/dermatomyositis Anti Ro/LA = Sjorgens Anti ANa = SLE Anti basement membrane = Goodpasteurs |
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Person comes in with coarse Facies, Staph abscesses, retianed primary teeth, High IgE, eczema. What do they prob have?
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Hyper IgE (Jobs syndrome) HINT= FATED
Th cells dont produce IF-y neutrophils cant respond |
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A person has chronic granulomatous disease. What is the defect and what infections are they more susceptible to?
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Catalase positive organisms
Deficiency in NADPH oxidase leading to decreased reactive oxygen species and the neutraphil cant burst bacteria |
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Antibody mediated type II reaction is involved with what kind of transplant rejection?
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Hyperacute
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How is chronic granulomatous disease treated?
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Interferon y
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What causes wet gangrene?
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bacteria
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Chronic inflammation is primarily mediated by what cell?
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Mononuclear cell
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Name some ways the body is injured by free radicals? (i.s. where they come from)
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radiation, metabolism of drugs, redox reaction, NO, transition metals, leukocyte oxidative burst
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High output failure is due to Cardiogenic or Septic shock?
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Septic
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What defines a cancer as in situ?
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Hasnt crossed the basement membrane, high nuclear to cytoplasma ratio, and clumped chromatin
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Desmoplasia?
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fibrous tissue formation in response to a neoplasm
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Matching:
abl MEN c-myc GIST bcl-2 breast, ovarian erb-B2 CML ras Neuroblastoma L-myc lung tumor N-myc Burkitts ret Colon cancer c-kit follicular lymphoma |
abl = CML
c-myc= Burkitts bcl-2= follicular erb-2= breast, ovarian ras-= colon cancer L-myc= lung N-myc= neuroblastoma Ret = MEN c-kit= GIST |
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Ethylene glycol, Alcohol, and methanol use the same enzyme alcohol dehydrogenase to break down. What are the products that each produce?
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ethylene glycol= oxalic acid= acidosis and nephrotoxicity
methanol=formaldehyde= acidosis and retinal damage alohol =acetalaldehyde |
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commons SE of sulfa drugs are......
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SJ syndrome, fever, puritic rash, hemolytic anemia, thrombocytopenia, agranulocytosis, hives
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What drug can cause Fanconi syndrome?
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expired tetracycline
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What drugs cause a hemolysis in G6PD patients?
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INH, Sulfa, Primaquine, Aspirin, Ibuprofen, Nitro
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What is the antidote to B-blockers?
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glucagon
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What does a Beta blocker do for glaucoma?
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decrease aqueous humor production
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Patient comes in with "spells" of increased BP, heart rate, and sweating. What do you treat them with?
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Phenoxybenzamine or phentolamine (alpha blockers)
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Difference in Epi and Phenylepi
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Epi is an agonist of everything including Beta 1 at low dose. Phenyepi likes alpha 1 > alpha 2. no beta activity
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Patient comes in with motion sickess... Which of the following would you use to treat this patient? Scopolamine, Oxybutinin, Benzotropine, Atropine, Hexamethonium
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Scopolamine
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What are most of the muscarinic agonists used for?
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glaucoma or post op ileus
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How does cocaine and amphetamines work on the nerves?
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prevent the reuptake pf ACH so constantly stimulated
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What is the difference in the D1 and D2 receptor?
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1 is on the renal vascular smooth muscle causing relaxation.
2 is on the brain |
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Tell me about the innervation of the sweat glands....
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Sympathetic. Nicatinic on the ganglion cells for preganglionic and Muscarinic on the gland for post ganglionic
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What does a competitive antagonist, irreversible antagonist, and a partial agonist look like on the pharmicodynamic curve?
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competitive= shift to right
irreversible=shift to right and down partial agonist shift to the left and down |
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Zero vs First order elimination????
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Zero = (aspirin, alcohol, phenytoin) constant amount of drug eliminated regardless of dose
1st= constant fraction of drug eliminated |
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What is the effect of a competitive inhibitor on Vmax, Km, and the pharmacodynamics?
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unchanged Vmax, d=increased Km, and decreased potency
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Where do you see a decrease in ESR?
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Polycythemia, CHF, and Sickle Cell
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What is a psammoma body and where do you see them?
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laminated cocentric calcifications
Papillary adenocarcinoma of the thyroid Serous papillary cystadenoma of ovary Meningioma, Malignant mesothelioma |
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Where do you see B-hCG tumor markers?
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Hydatidiform moles, Choriocarcinomas, Gestational trophoblastic tumors
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