Boards - Bbc Session 2

Front 1

Chronic inflamm features?

Back 1

pallor
Coolness
stiffness

Front 2

Acute inflamm features?

Back 2

redness (rubor)
pain (dolor)
heat (calor)
Swelling (tumor)

Front 3

Mediators of inflamm?

Back 3

prostaglandins
NO
IL-1
Histamine
Bradykinin
C5a
IL-8
C3b

Front 4

What feature of inflamm do histamine and bradykinin share?

Back 4

Exudation (=oozing forth)

(bradykinin ALSO does pain and vasodilation, like prostaglandins)

Front 5

What does C3b do in inflamm?

Back 5

opsonization --> phagocytosis

Front 6

What feature of inflamm do C5a and IL-8 share?

Back 6

chemotaxis

Front 7

Define MHC

Back 7

Major Histocompatibility Complex - an area of chromo 6

Front 8

Define HLA

Back 8

Human Leukocyte Antigens = group of proteins found on certain cell surfaces that represent the protein products of histocompatibility gene expression

Front 9

Class I Human Leukocyte Antigens (HLA) are found where?

Back 9

On all nucleated cells (note: RBCs DON'T have a nucleus)

Front 10

Class II Human Leukocyte Antigens (HLA) are found where?

Back 10

On antigen presenting cells: macrophages, B cells, dendritic cells (including Langerhan's cells), All APCs have class II antigens on cell surface

Front 11

Which cytokine stimulates proliferation of bone marrow to create B and T cells?

Back 11

IL-7

Front 12

Which cytokine leads Macrophages, T cells, B cells and granolocytes to have an anti-viral effect by inducing MHC-1 and inhibiting viral mRNA translation

Back 12

INF-alpha

Front 13

Which cytokine works on platelet endothelial cells to promote proliferation of vascular sm. muscle and healing?

Back 13

PDGF Platelet-derived growth factor

Front 14

Fibroblasts use what cytokine to have an anti-viral effect by inducing MHC-1 and inhibiting viral mRNA translation?

Back 14

INF-Beta

Front 15

What cytokine leads macrophages to produce fever and cachexia?

Back 15

TNF-alpha

Front 16

Role of the cytokine IL-3?

Back 16

Stimulate bone marrow

Front 17

Role of the cytokine TGF-alpha?

Back 17

stimulate angiogenesis and tumor growth

Front 18

Role of the cytokine TGF-beta?

Back 18

Inhibits T cells and promotes collagen formation

Front 19

Role of the cytokine TNF-alpha

Back 19

Fever, inhibits lipoprotein lipase, stimulates acute phase response as well as T and B cells (note, TNF-beta has similar actions)

Front 20

What cytokine stimulates bone marrow?

Back 20

CSF, colony stimulating factor

Front 21

Role of the cytokine RANTES

Back 21

RANTES = regulated and normal T cell expressed and secreted chemokine

Chemotaxis of monocytes

Front 22

Role of the cytokine SRS-A?

Back 22

Slow-reacting substances of anaphylaxis; leukotrienes.

Mediates exudation, vasoconstriction, and bronchoconstriction

Front 23

Role of the cytokine IL-6

Back 23

fever. stimulates acute phase response

Front 24

What cytokines start the acute phase response as a result of immune system activation?

Back 24

IL-1, IL-6, TNF-alpha

Front 25

What does the liver do in response to the production of IL-1, IL-6, TNF-alpha?

Back 25

Liver produces acute phase proteins, like c-reactive proteins, serum amyloid proteins, complement proteins, fibrinogen, prothrombin and other proteins

Front 26

Which complement proteins stimulate mast cells, basophils and platelets to release histamine?

Back 26

C3a and C5a (=Anaphylotoxins)

Front 27

Purpose of opsonins?

Back 27

coat foreign substances, allowing them to be more easily phagocytosed

Front 28

What activates the classical pathway of the complement system? (complement proteins are those that are produced by the liver to carry out vital activities of the immune system)

Back 28

Antigen-Ab complex

Front 29

How does a membrane attack complex work?

Back 29

lands on whatever cell/microbe its manufactured on and allows water and electrolytes to flow in and out causing its death.

Front 30

Antidote for Acetominophen?

Back 30

N-acetylcysteine

Front 31

Antidote for Anticholinergics?

Back 31

Physostigmine

Front 32

Antidote for Benzodiasepines?

Back 32

Flumazenil

Front 33

Antidote for Beta-Blockers?

Back 33

Glucagon and Calcium

Front 34

Antidote for Carbon Monoxide?

Back 34

Oxygen

Front 35

Antidote for Cyanide?

Back 35

Amyl nitrate

Front 36

Antidote for Digoxin?

Back 36

Anti-digoxin Fab Abs

Front 37

Antidote for Ethylene glycol?

Back 37

Ethanol

Front 38

Antidote for Heparin

Back 38

Protamine

Front 39

Antidote for Iron

Back 39

Deferoxamine

Front 40

Antidote for Isoniazid?

Back 40

Pyridoxine

Front 41

Antidote for Lead?

Back 41

EDTA or BAL

Front 42

Antidote for Methanol?

Back 42

Ethanol

Front 43

Antidote for Opioids?

Back 43

Naloxone

Front 44

Antidote for Warfarin?

Back 44

Vit. K

Front 45

Antidote for Organophosphates?

Back 45

Atropine or Pralidoxime

Front 46

Overdose of Acetominophen causes what?

Back 46

Liver failure

Front 47

Overdose of an anticholinergic (=block Ach) presents with what symptoms?

Back 47

"dry as a bone, mad as a hatter, blind as a bat"

Anhidrosis, fever, delirium, mydriasis

Front 48

Opiate over dose causes what symptoms? (opiates = morphine, heroin, codeine)

Back 48

"MORPHINE"
Miosis
Out if it (sedated)
Respiratory depression
Pneumonia (aspiration)
Hypotension
Infrequency (constipation, urinary retention)
Nausea
Emesis

Front 49

Over dose symptoms of Benzodiazepines (=sedative, tranquilizer, antidote to alcohol withdrawal)?

Back 49

Sedation and life-threatening respiratory depression

Front 50

Over-dose of methanol presents as (=in anti-freeze and known as wood alcohol. component of improperly made wines)?

Back 50

Abdominal pain and permanent blindness

Front 51

Ethylene glycol poisoning (in anti-freeze)?

Back 51

Renal failure

Front 52

A pt accidentally injested Ethylene glycol and methanol, so you give them ethanol as an antidote. If you overdose them of ethanol, what side effects can you expect to see that are due to the ethanol?

Back 52

Abdominal pain, respiratory depression, stupor, coma, death

Front 53

Carbon monoxide is a product of what?

Back 53

incomplete combustion

Front 54

If you heat your home with oil or gas, have a car with a faulty exhaust system, or leave your car running in a closed garage, you are at increased risk of what type of poisoning?

Back 54

carbon monoxide

Front 55

How does carbon monoxide work to cause death?

Back 55

binds Hb with greater affinity than Oxygen but ULTIMATELY causes death by DIRECTLY inhibiting the electron transport chain (respiration) in the mitochondria of cells

Front 56

Cyanide causes death how?

Back 56

Reacting with and inactivating respiratory enzymes (electron transport pathway in mito) preventing production of ATP

Front 57

How do organophosphates work to stimulate skeletal muscle motion?

Back 57

Cholinesterase inhibitors ie the enzyme that breaks down Ach is inhibited thus we have more Ach and stimulation of its receptors ie skeletal muscle stimulation and parasymps.

Front 58

Malathion is what kind of drug?

Back 58

organophosphate ie cholinergic agent

Front 59

What happens if you OD on Cholinergics>

Back 59

"SLUDGE"
Salivation
Lacrimation
Urination
Defecation
GI upset (diarrhea, cramps, etc)
Emesis

Front 60

A farmer OD's on malathion. What antidote do you give him?

Back 60

Atropine = an anti-cholinergic (=relieves muscle spasm and parasympathetic overdrive leading to sm. m. relaxation and pupil dilation)

Front 61

Action of Pralidoxime ie "2-PAM"?

Back 61

Restores cholinesterase activity (= the enzyme that breaks down Ach)

Front 62

A plumber accidentally ingested lead. whats is MOA in terms of causing adverse reactions? What do you give him for antidote?

Back 62

inhibits Hemoglobin production pathway

Antidote = EDTA

Front 63

MOA of Coumadin?

Back 63

Anti-coagulant that inhibits factors II, VII, IX, X ("1972" ie 10, 9, 7, 2)

Front 64

Old lady pt has a thrombus and an embolism so is put on Heparin. How does it work? Whats do you look for in terms of over dose?

Back 64

Prevents caog by activating anti-thrombin III.

Overdose = hemorrhage

Front 65

How do penicillins and cephalosporins work?

Back 65

Act to inhibit cell wall synthesis

Front 66

What are the Aminoglycosides? What's their MOA?

Back 66

Gentamicin, Amikacin, Neomycin, Streptomycin, Tobramycin.

Inhibit initiation of translation (ie inhibit ability to read RNA to make protien in bact thus inhibiting protein synth)

ONLY work for AEROBIC gram negatives!!!

Front 67

Pt has been on an antibiotic for a couple weeks and starts noticing hearing loss. What class of Abx was he most likely on?

Back 67

Aminoglycosides (Gentamicin, Amikacin, Neomycin, Streptomycin, Tobramycin)

NOTE: ototoxicity significantly increases with use of Loops like furosemide

Front 68

MOA of Vancomycin?

Back 68

Inhibits phospholipid plasma membrane synth and peptidoglycan polymerization (ie main component of cell wall) = inhibits cell wall synth.

Front 69

Pt acquires meth-resistant staph. a. infection. DOC?

Back 69

Vancomycin

Front 70

MOA of Quinolones?

Back 70

Inhibit Topoisomerase = inhibit bact. ability to use its own DNA

Ciprofloxacin, gatifloxacin, gemifloxacin, levofloxacin, moxifloxacin, ofloxacin

Front 71

Whats the big side effect of Quinolones and why you need to NOT use them in pple under 16 or Over 60? What are some other Side Effects?

Back 71

tendon rupture (tendinopathy)

Inc. QT Interval --> Torsades (so DON'T use with drugs that can inc. QT interval like azoles, NNRTIs, protease inhibs, nicardipine, TCAs, anti-arrhythmics, anti-psychotics, some SSRIs)

Front 72

MOA of Chloramphenicol?

Back 72

inhibits peptidyl transferase = enzyme needed for protein synth ie its a protein synth inhibitor

Front 73

MOA of Erythromycin?

Back 73

Inhibit protein synth (erythromycin class ie macrolides all do this)

Front 74

MOA of tetracyclines?

Back 74

Ex = Doxycycline, tetracycline, minocycline, tigecycline = inhibit tRNA binding and inhibit protein synth

Front 75

MOA of sulfonamides?

Back 75

inhibit folate synth

Front 76

MOA of trimethoprim?

Back 76

inhibit folate use

Front 77

Bacitracin is only used in what form for what reason?

Back 77

Topically, because its nephrotoxic

Front 78

Polymyxin is used for what bacteria?

Back 78

Pseudomonas aeruginosa (its an anti-pseudomonal agent)

Found in opthalmic preparations

Front 79

Carpapenems like doripenem, ertapenem, imipenem and meropenem work how?

Back 79

cell wall synth = high affinity for penicillin binding proteins in bacteria

Broad Anti-bacterial activity

Work on most Gram pos and many Gram negs including Enterobacteriaceae

Front 80

Glycopeptides like teicoplanin and vancomycin cell wall inhibitors are effective against what type of bact?

Back 80

Gram pos., especially used for serious gram pos. infections

Front 81

Red man syndrome ie erythema and hypotension caused by glycopeptide-mediated histamine release is caused by what Abx?

Back 81

Glycopeptides

Front 82

Clindamycin MOA?

Back 82

protein synth inhibitor

Front 83

Metronidazole MOA?

Back 83

activates things that destroy microbial DNA

Works for Anaerobic and many protozoa

Front 84

Preggo pt has a UTI. DOC?

Back 84

Nitrofurantoin = inhibits bact. enzymes by accumulating in urine. (DOC for UTI in preggos). Inhibits bacterial enzyme system

Front 85

Empiric treatment of Osteomyelitis?

Back 85

Less than 4 months old = nafcillin or oxacillin + ceftazidime or cephapime

All others: nafcillin or oxacillin

Front 86

Empiric treatment of Any Encephalitis?

Back 86

Acyclovir until HSV PCR results return. If HSV +, continue Acyclovir

Front 87

Empiric treatment of Meningitis?

Back 87

Neonate = Ampicillin + Cefotaxime
Child/Adult = Ceftriaxone or cefotaxime + dexamethasone + vancomycin
Over 50 years old, Alcoholics, or anyone with severe debilitating co-morbid disease or anyone who is immunocompromised = deftriaxine or cefotaxime + dexamethasone + vancomycin + ampicillin

Front 88

Empiric treatment of Meningitis Prophylaxis of close contacts?

Back 88

H. influenzae = rifampin
Neisseria menigitidis = rifampin (preferred) or ceftriaxone or ciprofloxacin

Front 89

Empiric treatment of Otitis Externa?

Back 89

Ofloxacin drops or (polymyxin+neomycin+ hydrocortisone drops) or (ciprofloxacin + hydrocortisone drops)

Front 90

Empiric treatment of Otitis Media?

Back 90

Amoxicillin if less than 2 years old. (if greater than 2 years old, afebrile, with no pain, = analgesics)

Front 91

Empiric treatment of Conjunctivitis - NON neo-natal?

Back 91

Viral conjunctivitis (pink eye) = nothing, or chilled artificial tears

Bacterial conjunctivitis (non-gonococcal, non-chlamydial) = Fluoroquinolones by drops

Front 92

Empiric treatment of Conjunctivitis Neo-natal?

Back 92

Newborn, onset within 1st day = nothing
Newborn, onset within 2nd-4th day = IV ceftriaxone
Newborn, onset within 3rd - 10th day = PO erythromycin
Newborn, onset within 2nd to 16th day WITH EVIDENT dendritic corneal ulcer = trifluridine drops and IV Acyclovir

Front 93

Prophylaxis against opthalmia neonatorum?

Back 93

tetracyclin ointment OR erythromycin ointment

Front 94

Treatment of diarrhea in premature baby?

Back 94

Piperacillin + tazobactam OR ampicillin + sulbactam

Front 95

Treatment of diarrhea in post-antibiotic use pts?

Back 95

Metronidazole

Front 96

Treatment of diarrhea in travel-associated pts?

Back 96

Fluoroquinolones or Rifaximin

(Diarrhea prophylaxis during travel = Fluoroquinolones, then imodium with first loose stool.

Front 97

Mild-moderate Diarrhea treatment?

Back 97

Fluids + Lactose and caffeine-free diet

Front 98

Severe Diarrhea treatment?

Back 98

Ciprofloxacin or Levofloxacin PLUS metronidazole PLUS fluids, lactose, and caffeine-free diet

Front 99

Treatment for acute bronchitis?

Back 99

Antitussives +/- inhaled beta 2 agonists

Front 100

Treatment for Anthrax prophylaxis (post-exposure)?

Back 100

Ciprofloxacin

Front 101

Treatment for Pneumonia?

Back 101

Less than 1 month old = Ampicillin + Gentamicin + /- Cefotaxime
1-3 months old = Erythromycin or Azithromycin (add cefotaxime if febrile)
3 months - 18 years old = Ampicillin +/- azithromycin +/- vancomycin
Older than 18 = Ceftriaxone OR ertapenem + azithromycin

Front 102

Treatment of Prostatitis?

Back 102

Less than 35 years old = Ceftriaxone or Cefixime, then doxycycline or and fluro or TMP-SMX

Older than 35 = Any fluroquinolone or TMP-SMX

Front 103

Treatment of Sepsis?

Back 103

Neonate less than 1 week old = amp + cefotaxime
Neonate greater than 1 week old = amp + cefotaxime OR amp + ceftriaxone
Child = Vanc + Cefotaxime or Ceftriaxone
Adult = Any carbapenem PLUS vancomycin
Adult with fever and hypotension = Abx of organism + fluids + Norepinephrine + Low dose steroids + blood glucose control with target range 150-180 mg/dL +/- activated protein C

Front 104

Treatment of UTI?

Back 104

Outpatient = TMP-SMX
Inpatient = Ciprofloxacin or Levofloxacin
Preggo = Nitrofurantoin

Front 105

Treatment for human or animal bite?

Back 105

Amoxicillin-clavulanic acid + consider anti-rabies prophylaxis

Front 106

Bacillus cereus DOC?

Back 106

Vanc or Clindamycin

Front 107

Borrelia burgdorferi DOC?

Back 107

Doxy

Front 108

Campylobacter jejuni DOC?

Back 108

1st line: Azithromycin then Erythromycin

Front 109

ALL pts who are bitten by racoon, skunk or bat get what? (note: NOT rat or human bites unless rabies evident in biter)

Back 109

Rabies vaccine

Front 110

Candida spp. DOC?

Back 110

Miconazole for skin/vagina/ Fluconazole for systemic infection

Front 111

Chlamydia trachomatis DOC?

Back 111

Doxy

Front 112

Clostridium difficile DOC?

Back 112

Metronidazole

Front 113

Corynebacterium diptheriae DOC?

Back 113

Erythromycin

Front 114

Gardnerella vaginalis DOC?

Back 114

Metronidazole

Front 115

Hemophilus ducreyi DOC?

Back 115

Azithromycin +/- Ceftriaxone

Front 116

Hemophilus influenza DOC?

Back 116

Cefotaxime or Ceftriaxone

Front 117

Mycoplasma pneumoniae DOC?

Back 117

Azithromycin +/- Cipro

Front 118

Neisseria gonorrhea DOC?

Back 118

Ceftriaxone + Doxy

Front 119

Neisseria meningitidis DOC?

Back 119

Pen G

Front 120

Bacillus anthracis DOC?

Back 120

Penicillin

Front 121

Listeria monocytogenes DOC?

Back 121

Amp

Front 122

Pasteurella multocida DOC?

Back 122

Amoxicillin-Clavulanate or Cefuroxime

Front 123

Salmonella typhi DOC?

Back 123

Cipro or Levo

Front 124

Shigella species DOC?

Back 124

Azithro or Cipro

Front 125

Treponema pallidum DOC?

Back 125

Pen G

Front 126

Trichomonas vaginalis DOC?

Back 126

Metronidazole

Front 127

Staph aureus DOC?

Back 127

Oxacillin or Nafcillin, dicloxacillin if on skin.

If methicillin resistant (MRSA) = vancomycin

Front 128

Strep pyogenes DOC?

Back 128

Pen G or V

Front 129

Genital warts DOC?

Back 129

Podophyllin resin OR cryotherapy or trichloroacetic acid

Front 130

GBS (Group B Strep) Prophylaxis for pregnant females?

Back 130

Pen G (during labor)

Front 131

Staph saprophyticus DOC?

Back 131

Any Cephalosporin or Amoxicillin-clavulanic acid

Front 132

Strep pneumoniae DOC?

Back 132

Pen G

Front 133

Vibrio cholera DOC?

Back 133

Doxy OR Azithro

Front 134

Giardia lamblia DOC?

Back 134

Tinidazole or Nitazoxanide

Front 135

Entamoeba histolytica DOC?

Back 135

Metronidazole or tinidazole

Front 136

Ascaris lumbricoides DOC?

Back 136

Albendazole or Mebendazole

Front 137

Enterobius vermicularis DOC?

Back 137

Mebendazole

Front 138

Necator americanus DOC?

Back 138

Albendazole or Mebendazole

Front 139

Trichinella spiralis DOC?

Back 139

albendazole + prednisone

Front 140

Schistosoma spp. DOC?

Back 140

Praziquantel

Front 141

Diphyllobothrium latum DOC?

Back 141

praziquantel

Front 142

Adenovirus DOC?

Back 142

Cidofovir + Probenecid

Front 143

Influenza A DOC?

Back 143

Zanamivir or Oseltamivir

Front 144

Influenza B and Avian flu (H5N1) DOC?

Back 144

Zanamivir or Oseltamivir

Front 145

Measles DOC?

Back 145

Vit A (children) or ribavirin +/- Vit. A (adults)

Front 146

Smallpox DOC?

Back 146

smallpox vaccine (within 4 days of exposure) + Cidofovir + Probenecid

Front 147

What is the purpose of the Uncovertebral joints of Luschka on the cervical vertebrae?

Back 147

Provide stability to that region of the spine to lessen the possibility of a herniated nucleus pulposus at each level.

Front 148

Location of the alar ligament of the cervical vertebrae?

Back 148

Connects sides of the odontoid process to the lateral aspects of the foramen magnum

Front 149

Role of anterior and middle scalene muscles in respiration?

Back 149

Aid in elevating the 1st rib

Front 150

Role of posterior scalene muscle in respiration?

Back 150

Elevation of 2nd rib

Front 151

Where do the cervical nerve roots exit the spine?

Back 151

C1-C7 emerge above their corresponding vertebra.

C8 emerges below cervical vertebra 7

Front 152

What nerve roots does the brachial plexus emerge from?

Back 152

C5-T1 nerve roots

Front 153

Primary motion of Occipitoatlantal (OA) joint? Rotation and Sidebending?

Back 153

Primary motion = Flexion/Extension. Rotation and Sidebending occur in opposite directions

Front 154

Primary motion of Atlantoaxial (AA) joint? Rotation and Sidebending?

Back 154

Primary motion = Rotation. Rotation and Sidebending = opposite directions

Front 155

How do you check cervical vertebrae of the occipitoatlantial joint, upper cervical and lower cervical?

Back 155

Translation (AA are checked via rotation). For ex. if you translate cervical vertebrae to the right, they will sidebend left. Check for restriction with this motion in neutral, flexion, and extension

Front 156

What clotting factors are directly affected by a deficiency in vitamin K?

Back 156

"1972"

10, 9, 7, 2

Front 157

Name the 3 things that may trigger sickling in sickle cell anemia

Back 157

Hypoxia, Dehydration, Acidity

Front 158

What type of pneumonia may result in the production of cold antibodies?

Back 158

Mycoplasma

Front 159

Deficiency of what may result in megaloblastic anemia and neurological symptoms?

Back 159

B12

Front 160

What type of cell will rise in number in the blood following a severe hemorrhage?

Back 160

Reticulocyte

Front 161

If a pt. were infected with parasites, what type of WBC would you expect to see increased in number?

Back 161

Eosinophils

Front 162

Which type of leukemia is associated with the presence of the Philadelphia chromo?

Back 162

CML

Front 163

What cell type is classic in the diagnosis of Hodgkin's disease?

Back 163

Reed-sternberg cell

Front 164

What disorder is associated with osteolytic lesions in the skull and pelvis, along with Bence-Jones proteins in the urine?

Back 164

Multiple Myeloma

Front 165

What are the three features of Virchow's triad?

Back 165

Stasis, Endothelial injury, Hypercoagulability

Front 166

What type of arteritis must be diagnosed early in order to prevent blindness?

Back 166

Giant cell (Temperal)

Front 167

What kind of aneurysm if often associated with polycystic kidney disease?

Back 167

Bony

Front 168

What type of congenital heart anomaly is characterized by a continuous machine like murmur?

Back 168

PDA, Patent Ductus Arteriosus

Front 169

What is Eisenmenger Syndrome?

Back 169

Reverse of L--> R shunt to R--> Left shunt

Front 170

In ischemic heart disease, what two different conditions can an ST segment elevation often represent?

Back 170

Prinzemental's angina
MI

Front 171

What are the 4 major complications that may follow an MI?

Back 171

Arrhythmia, CHF, Muscle Rupture, ______ shock

Front 172

Is dypsnea and orthopnea a result of right-sided or left-sided heart failure?

Back 172

Left

Front 173

What kind of endocarditis are those with previously damaged or abnormal heart valves more at risk of getting? What are te common organisms responsible for this?

Back 173

Subacute.

Strep. viridans and Gram neg. Bacilli

Front 174

What syndrome involving the pericardium may occur following an MI?

Back 174

Dressler's syndrome

Front 175

What are the 5 features of the major Jones Criteria?

Back 175

Polyarthritis, Carditis, Subacute nodules, Erythema marginatum, Chorea

Front 176

Name the four major classifications of lung disease that represent obstructive lung disease

Back 176

Asthma
Emphysema
Chronic Bronchitis
__________?

Front 177

What restrictive lung disease is caused by the habitual inhalation of irritants such as coal dust and silica?

Back 177

Pneumoconiosis

Front 178

What is the drug of choice for vaginal candidiasis? Systemic candidiasis?

Back 178

Vaginal candidiasis = Metronidazole

Systemic Candidiasis = Fluconazole

Front 179

What is the DOC for N. meningitis N. gonorrhea?

Back 179

N. meningitis = Pen G

N. gonorrhea = Ceftriaxone

Front 180

Name the three anatomical aspects of the cervical vertebrae that differ from other spinal vertebrea

Back 180

Bifid spinous process
Uncinate process
Transversarium Foramen

Front 181

What ligament connects the dens to the foramen magnum?

Back 181

Alar Ligament

Front 182

Which scalenes aid in elevation of the first rib?

Back 182

Anterior and Middle

Front 183

If you are able to induce left translation, what type of sidebending are you inducing?

Back 183

Right

Front 184

If the occiput is rotated right, in what direction is it sidebent?

Back 184

Left

Front 185

If you are about to perform OMT, on the cervical spine, in what area would one generally start?

Back 185

OA

Front 186

What is the antidote for acetominophen Overdose?

Back 186

N-acetylcysteine

Front 187

What anti-tuberculosis drug is notorious for its hepatotoxicity?

Back 187

Isoniazid

Front 188

Name the drugs that we studied to be P450 inducers

Back 188

OCP, Phenytoin, Barbiturates, Alcohol, Rifampin, L_______, M_______?

Front 189

Auto-antibody involved in SLE?

Back 189

Anti-nuclear Ab (ANA) for screening, Anti-ds DNA for confirmation

Front 190

Auto-Ab involved in Drug-induced lupus?

Back 190

Anti-histone

Front 191

Auto-Ab involved in CREST?

Back 191

Anti-centromere

Front 192

Auto-Ab involved in Myasthenia Gravis?

Back 192

Anti- ACh receptor

Front 193

Auto-Ab involved in Grave's disease?

Back 193

Anti-TSH receptor

Front 194

Auto-Ab involved in Hashimoto's Thyroiditis?

Back 194

Anti-microsomal

Front 195

Auto-Ab involved in Wegener's granulomatosis?

Back 195

Anti-neutrophil cytoplasm (ANCA)

Front 196

Auto-Ab involved in Celiac Sprue?

Back 196

Anti-gliaden

Front 197

Auto-Ab involved in Goodpasture's syndrome?

Back 197

Anti-glomerular basement membrane (anti-GBM)

Front 198

Auto-Ab involved in Primary biliary cirrhosis?

Back 198

Anti-mitochondrial

Front 199

What mediates Type I Hypersensitivity Reactions?

Back 199

IgE

Front 200

Whats the only hypersensitivity that does NOT involve Abs?

Back 200

Type IV - involves macrophages and T cells, ie its cell-mediated

Front 201

Which hypersensitivity rxn involves immune complex deposition?

Back 201

Type III

Front 202

Which hypersensitivity rxn involves Ab-mediated cytotoxicity?

Back 202

Type II

Front 203

Rh- mom has Rh+ baby. Her second child is also Rh+. What type of hypersensitivity rxn occurs upon her second pregnancy?

Back 203

Type II, ie Ab-mediated cytotoxicity means that the second babies tissues will swell with fluid ie vessels LOSE fluid --> erythroblastosis fetalis --> hydrops fetalis

Front 204

A pt presents with an erythmatous rash after having done some gardening in a poison ivy patch. What type of hypersensitivity rxn is this?

Back 204

Type IV cell-mediated

Front 205

Drugs like penicillin can cause what types of hypersensitivity rxns?

Back 205

Types I, II, III

Front 206

Map out the Classical Complement pathway

Back 206

C1 --> C2 and C4 --> C3a (naphylotoxin) and C3b (opsonin = coats stuff) and C4b2bC3b (=C5 convertase) --> C5a and C5b --> C6, C7, C8, C9 --> MAC (=C5-C9)

Front 207

Map out the Alternate pathway of the complement pathway

Back 207

Endotoxin, Cobra venom or Complex polysaccharides C3 and B --> Factor D --> C3bBb (alternate convertase) --> C3a (anaphylotoxin) and C3b (opsonin = coats stuff) and C4b2bC3b (=C5 convertase) --> C5a and C5b --> C6, C7, C8, C9 --> MAC (=C5-C9)

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Auto-Ab involved in Auoimmune hemolytic anemia?

Back 208

Anti-RBC

Front 209

Auto-Ab involved in Bullous Pemphigoid?

Back 209

Anti-epidermal basement membrane

Front 210

Auto-Ab involved in Type I diabetes mellitus (insulin-dependent diabetes mellitus)?

Back 210

Anti-islet cell

Front 211

Auto-Ab involved in Pemphigus?

Back 211

Anti-keratinocyte junction

Front 212

Auto-Ab involved in Pernicious anemia?

Back 212

Anti-intrinsic factor, anti-parietal cell

Front 213

Auto-Ab involved in Microscopic polyangitis?

Back 213

p-ANCA (peri-nuclear anti-neutrophil cytoplasm)

Front 214

Auto-Ab involved in Polymyositis?

Back 214

Speckled ANA (Anti-nuclear Ab) (20% also have anti0Jo-1)

Front 215

Auto-Ab involved in Progressive systemic sclerosis (scleroderma)?

Back 215

Anti-Slc 70

Front 216

Auto-Ab involved in Idiopathic thrombocytopenic purpura (adult form)?

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Anti-structural platelet

Front 217

Auto-Ab involved in Vitiligo?

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Anti-melanocyte

Front 218

What oncogene is mutated in Burkitt Lymphoma?

Back 218

c-myc (when NOT mutated and hence ACTIVE, helps prevent this cancer)

Front 219

Whats the mutated oncogene in chronic myelogenous leukemia? (CML)

Back 219

a-abl (when NOT mutated and hence ACTIVE, helps prevent this cancer)

Front 220

What tumor supressor gene is mutated in breast and ovarian cancer?

Back 220

BRCA-1

Front 221

What gene is mutated in breast, coon and lung carcinomas?

Back 221

p53

Front 222

In what conditions will we see an increased alpha-fetoprotein, a tumor marker?

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Hepatoma (hepatocellular carcinoma), Multiple Gestation, Neural tube defect (ex. = spina bifida, anencephalus), yolk sac tumor/ endodermal sinus disease

Front 223

If Alpha fetoprotein (AFP) is low in a pregnant woman, what should we be concerned about?

Back 223

Down's Syndrome

Front 224

What does an elevated CEA tell us about the state of a mass in a pt?

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CEA = carcinoembryonic antigen. There may be an adenocarcinoma.

Front 225

Pt has an elevated PSA. What is this tumor marker used for?

Back 225

PSA = prostate specific antigen. prostate cancer

Front 226

Pt has an elevated acid phosphatase. What tumor are we concerned about this pt having?

Back 226

prostate cancer

Front 227

Alkaline Phosphatase is used to track or diagnose tumors produced in different places. What places?

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Bone - Bone Cancer - Alkaline Phosphatase produced in growing bone, so kids and adolescents will naturally have high alkaline phosphatase. Also, pple with fractured bone will have inc. alkaline phosphatase
Kidneys - Renal cell carcinoma
Placenta
Biliary System - to Dx NON-Neoplastic disease of biliary system, like gallbladder infection

Alkaline Phosphatase is normally produced in all these places.

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Pt has an increased 5'-HIAA (5'=hydroxyindole acetic acid). What cancer are we concerned about?

Back 228

carcinoid

Front 229

Pt has an increased CA 19-9. What cancers are we concerned about?

Back 229

Colon, Pancreatic or Breast cancer

Front 230

Pt has an increased CA 125. What cancer are we concerned about?

Back 230

Ovarian cancer

Front 231

Pt has an increased CD 25. What cancer are we concerned about?

Back 231

Hairy Cell leukemia

Front 232

Pt has an increased CD 30. What cancer are we concerned about?

Back 232

Hodgkin's disease

Front 233

Pt has an increased Neuron-specific endolase. What cancer are we concerned about?

Back 233

Small cell lung cancer, Neuroblastoma

Front 234

Pt has an increased Human Chorionic Gonadotropin (beta-hCG). What cancer are we concerned about?

Back 234

Pregnancy, gestational trophoblastic disease (hydatidiform mole), choriocarcinoma

Front 235

Whats the most common place for lung cancer to metastasize to?

Back 235

Brain

Front 236

Whats the most common place for breast cancer to metastasize to?

Back 236

Bone

Front 237

Define Hypophosphatemic rickets

Back 237

X-linked dominant inherited dysfunction in vitamin D receptor --> bowed legs

Front 238

Define Incontinentia pigmenti

Back 238

X-linked dominant inherited disorder. Mini-teeth and patchy alopecia (hair loss)

Front 239

If you do a punnet analysis of a family, and can't figure out the inheritance pattern (ie X-linked recessive, etc.) What two things should you consider?

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De novo mutation = a new mutation that appears in a family where its never been before.

Mitochondrial inheritance - based on the fact that ALL mitochondrial DNA are passed from mother to offspring - the father NEVER passes mitochondrial DNA to offspring. Therefore, if EVERY offspring of a mother has a disorder, its probably this inheritance pattern, mitochondrial inheritance (ex. = Leber's optic neuropathy = bilateral blindness with onset sometime after age 15)

Front 240

What will De Novo mutation look like in a pedigree?

Back 240

In healthy parents, ONE of the progeny undergoes a spontaneous mutation

Front 241

If a pt has a mitochondrial mutation, what tissues are more prone to damage?

Back 241

Tissues that are the most ATP-dependent will be affected most

Ex. = retina = one of the most ATP-dependent tissues in the body

Front 242

Two siblings inherited a mitochondrial mutation from their mother. One goes blind at age 16, the other goes blind at age 60. What can account for this?

Back 242

Mitochondrial inheritance mutations are variable in their expression of the disease. This can be in terms of timing OR severity

Front 243

Whats the most common lethal genetic disease of caucasians?

Back 243

Cystic Fibrosis, due to mutation in CFTR gene = defect in chloride transmembrane movement in epi cells

Front 244

Baby fails to pass a meconium in the first day of life. What two conditions are we worried about?

Back 244

Cystic fibrosis or Down's syndrome

Front 245

A pt presents with viscous mucus, recurrent respiratory infections, high NaCl in sweat and tears, Chronic pancreatitis (dysfunction of epi cells line pancreas = B islet cells destroyed = pancreatitis = type 1 like Diabetes), cholelithiasis (biliary ducts lined with epi, and malnutrition (due to poor bowel function from less pancreatic secretions = fatty stool, steatorrhea). They note that they did not pass a meconium until day 3 of life. What condition do they have?

Back 245

Cystic Fibrosis

Front 246

What bacteria are cystic fibrosis pts particularly susceptible to?

Back 246

Pseudomonas aeruginosa - colonizes their lungs

Front 247

What are the fat soluble vitamins?

Back 247

ADEK

These are the vitamins we lose in cystic fibrosis because pancreatitis = lose pancreatic secretions, such as lipase = can't absorb fats = fatty stool, steatorrhea = lose fat-soluble vitamins ADEK

Front 248

Define Phenylketonuria

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Inability to metabolize phenylalanine = buildup of phenylalanine break down products and inability to make melanin and neurotransmitters Norepi and dopamine = leads to neurotoxicity = results in lighter complexion due to decreased melanin synthesis

We'll see lower levels of tryosine, which is made from phenylalanine

Front 249

Define Albinism

Back 249

Complete inability to make melanin, because tyrosine, made from phenylalanine, cannot be made into melanin

Front 250

What will a deficiency in alpha-1-antitrypsin cause?

Back 250

alpha-1-antitrypsin normally INHIBITS elastase, which breaks down elastin.

Without alpha-1-antitrypsin, elastase is fully active and digests all of the elastin, so tissues lose elastic recoil. The part of the body most affected is the lungs = lungs lose elastic recoil due to cirrhosis = lungs can be hyper-inflated ie emphysema results

Front 251

Whats the underlying dysfunction in Thalassemia, sickle cell anemia, Beta-Thalassemia?

Back 251

Abnormally structured Hemoglobin --> microcytic anemia

Front 252

What are the glycogen storage disease, where there is an inability to utilize glycogen (=the storage form of glucose) normally?

Back 252

Gierke disease, Pompe disease and McArdle disease

=these pts can make glycogen, they just can't "borrow from the bank" of glycogen to keep their glucose stable between meals

Front 253

What keeps us from becoming hypoglycemic after a meal?

Back 253

Glycogen. allows us to maintain normal glycemia between meals

Front 254

What are mucopolysaccharidoses?

Back 254

A group of disease due to a defect in lysosomes, so we can't degrade glycosaminoglycans = mucopolysaccharidoses (GAGs)

Mucopolysaccharides are critical to connective tissue = we start to form too much connective tissue, and can't break it down

Front 255

What symptoms allow us to differentiate between Hurler, Scheie and Hunter mucopolyssaccharidoses?

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Hurler and Scheie = Progressive Mental retardation (shceie is less-severe), corneal clouding

Hunter = Mental Retardation

Front 256

Hunter mucopolysaccharidosis desplays what genetic transmission?

Back 256

X-Linked recessive

Front 257

If we can't metabolize sphingolipidoses, wt disorder do we have?

Back 257

This is a type 1 lysosomal storage disease. We can't metabolize sphingolipids, a major component of the CNS and myelin.

Front 258

A pt presents with a spingolipidoses disease, but NO CNS symptoms. Which Sphingolipidoses disease do they have?

Back 258

Fabry's disease - this is the ONLY sphingolipidoses disease that present with NO CNS symptoms

Front 259

What are the Sphingolipidoses diseases?

Back 259

Neimann-Pick, Gaucher's, Krabbe's, Tay-Sachs, Metachromatic dystrophy, and Fabry's

Front 260

Which is the Only Sphingolipidosis disease to NOT have CNS symptoms and is X-linked recessive?

Back 260

Fabry's