Boards Boot Camp Comprehensive Flashcards: Segment 15

Front 1

Enterobacteriaceae (oxidase negative, ferments glucose) that causes UTI. Some strains produce a red pigment. Often hospital acquired and drug resistant. Buzzwords: motile, catheter associated, hospitalized

Back 1

Serratia marcescens

Front 2

Breast pain d/t costochondritis, pain is worse with respiration

Back 2

Tietze syndrome

Front 3

Breast pain d/t thoracoepigastric vein phlebitis. Skin retraction along vein course is seen

Back 3

Mondor's disease
(Hey mon! My tities sure are sore today)

Front 4

Breast tumor that has well defined boarders and possible calcifications.

Back 4

Fibroadenoma

Front 5

Quick run down of fibrocsytic breast disease

Back 5

MC 35-50
Found in terminal ductal lobe

Front 6

Breast cancer that cannot be detected clinically or by gross examination. Mammography is also a poor diagnostic means. Cytology shows mucinous cells always present with "saw tooth" and "clover leaf" config in ducts

Back 6

Lobar carcinoma in situ

Front 7

Breast cancer that exhibits a single file growth pattern within a fibrous stroma

Back 7

Invasive lobular carcinoma

Front 8

How to recognize and treat enteric fever (typhoid fever) caused by Salmonella typhi

Back 8

fecal-oral route
incubate for ~12 days
bacteria multiply in Payers Patches
Bacteria migrate to liver, GB, spleen
PE - Fever, relative bradycardia, constipation, "rose spots" on abdomen
tx ceftriaxone

Front 9

Exposure route for Shigella: 5 F's

Back 9

Fingers
Flies
Food
Feces
Fucking a butthole

Front 10

Big ol' staghorn calculi hurts like hell and is produced by __________. Will show a positive __________ ____________ test.

Back 10

proteus; phenylalanine deaminase

Front 11

Marine organism that causes watery diarrhea with NV, abdominal cramps, fever, and self-limited. Raw under cooked fish,shellfish, oysters

Back 11

Vibrio parahaemolyticus

Front 12

7 y/o pt presents with Mom with fever, severe abdominal pain, and watery foul-smelling diarrhea with intermittent blood. Mom claims sx began after the new family puppy, Fritzy, diarrhea-ed all over her child.

Back 12

Campylobacter jejuni

Front 13

Factors that favor the growth of B. frag

Back 13

low blood flow to gut (ischemia)
E. coli overgrowth - consumes all O2
necrosis

Front 14

pt presents with flu-like aches and pains with constipation and fever that is absent in the morning and high in the afternoon and evening. PE shows lymphadenopathy

Back 14

Brucellosis aka undulant fever
incubation period in 1-3 weeks

Front 15

What system does brucella tend to invade?

Back 15

reticuloendothelial system - lymph nodes, liver, spleen, and bone marrow

Front 16

Brucellosis can be obtained from different animals. Match the strain to the animal:
B. melitensis
B. abortus
B. suis

Back 16

goats and sheep (most severe)
cattle (least severe)
pigs
all cases via ingestion of milk products or direct skin contact with animal or its tissue

Front 17

Factors that favor the growth of B. frag

Back 17

low blood flow to gut (ischemia)
E. coli overgrowth - consumes all O2
necrosis

Front 18

Serious abdominal anaerobic infections that form abscesses in the gut and intra-abdominal

Back 18

B. frag

Front 19

pt presents with flu-like aches and pains with constipation and fever that is absent in the morning and high in the afternoon and evening. PE shows lymphadenopathy

Back 19

Brucellosis aka undulant fever
incubation period in 1-3 weeks

Front 20

What system does brucella tend to invade?

Back 20

reticuloendothelial system - lymph nodes, liver, spleen, and bone marrow

Front 21

Brucellosis can be obtained from different animals. Match the strain to the animal:
B. melitensis
B. abortus
B. suis

Back 21

goats and sheep (most severe)
cattle (least severe)
pigs
all cases via ingestion of milk products or direct skin contact with animal or its tissue

Front 22

Hunter presents with skin ulcer surrounded by granuloma, lymphandenopathy, and flu-like sxs.

Back 22

Francisella tularensis - transmitted by the Lone Star tick aka Amblyomma americanum (tick with white spot on backside)

Front 23

Farm hand presents with non-productive cough, dyspnea, and pleuritic chest pain.

Back 23

Tularemic pneumonia
may arise from hematogenous spread from standard tularemia

Front 24

Hemophilus tend to grow around _________ (satellites) on perti dishes. Why?

Back 24

Staph; staph helps release blood components

Front 25

Types of TB:
Pott's disease
Scrofulerma
Miliary TB

Back 25

Pott's disease - vertebral TB
Scrofulerma - cutaneous TB
Miliary TB - WIDESPREAD HEMATOLOGIC dissemination yielding "shot gun pellet" lesions in the lung, CNS, GI, kidney and bones

Front 26

GI TB spread how and caused by what?

Back 26

unpasteurized milk; M. bovis

Front 27

Mycobacterium the grows on cooler body regions, found in nasal secretions. + Feather test and can only be cultured on mice foot pads. Reservoir is armadillos

Back 27

M. leprae

Front 28

Granuloma at the site of abrasion exposed to swimming pool of fish tank

Back 28

M. marinum

Front 29

Mycobacterium that feeds off of dead tissue, causes skin abscesses at trauma sites, corneal ulcers in areas of corneal damage and pulmonary infection

Back 29

M. fortuitum

Front 30

Organism that causes Yaws (ulcerative lesions at site of infection, initial ulcers persist with additional widespread lesions + granulomas. Gummas of skin and bone)

Back 30

Treponema pertenue
Yaws - found in humid tropical areas

Front 31

Treponema pallidum subspecies endemicum causes "Bejel" endemic syphilis that presents like Yaws, but found in the middle east and Africa

Back 31

truth

Front 32

Presents like Yaws, except the lesions are red and eventually turn blue. There are no gummas in tertiary stage, instead the skin depigments. Pt hx to Rural Central America and South America

Back 32

Treponema carateum (Pinta)

Front 33

Pt presents with fever, drenching sweats, rash, and splenomegaly. Pt reports these same sxs presented about a week ago and have been remitted until today. Cause? Vector? Reason for lapse in sxs? Blood smear?

Back 33

Borrelia recurrentis
Vector is Lice
Reservoir are wild rodents in the Western US
visualize large SPIROCHETES (don't confuse with treponema nukka)
relapses d/t antigenic variation

Front 34

Pt presents with high spiking fever, headache, red eyes, and severe muscle aches in the lower back and thighs. You refuse to treat her because she smells like a sewer. She returns later with recurrence of sxs and signs of meningitis, but CSF is normal. Where does the causative organism reside? tx?

Back 34

This is Leptospirosis d/t infection with Leptospira interrogans
She was most likely swimming in a sewer or water contaminated with small animal piss. Shes a keeper.

**Weil's disease is exactly the same presentation + liver damage with jaundice, hemoptysis, and uremia with renal failure**

Front 35

All these lovelies are caused by:
non-gonococcal urethritis may progress to epidymitis or prostatitis
Cervicitis
PID
Lymphogranuloma venereum
Trachoma
Neonatal inclusion conjunctivitis
Conjunctivitis
Reiter's syndrome

Back 35

Chlamydia trachomatis

Front 36

Obvious hoe presents with painless papule on her hoe cooch that ulcerated and healed without incident. 2 months later she presents with swollen lymph nodes.

Back 36

Lymphogranuloma venereum

Front 37

Blindness that develops over 10-15 years from chronic conjunctivitis . Endemic to Africa and Asia

Back 37

Trachoma

Front 38

Drugs of choice:
chlamydial conjunctivitis
neonatal inclusion conjunctivitis
trachoma
chlamydial infection of genital tract

Back 38

dox
erythro
azithro
azithro or dox

Front 39

Standard of practice when pt presents with chlamydia infection

Back 39

assume they are concomitantly infected with gonorrhea, until ruled out by testing
Conversely, all cases of gonorrhea must be treated for chlamydial infection concomitantly

Front 40

Pet store owner presents with pneumonia and hepatitis sxs. He loves to cuddle with parrots. dx and tx

Back 40

Chlamydia psittaci
"psittacosis"
tx with tetracycline (dox)

Front 41

Clinical presentations of the following typhus and causative agent:
Epidemic
Endemic
Scrub
Ehrlichiosis

Back 41

R. prowazekii
R. typhi
R. tsutsugamushi
Ehrlichia
**all types of typhus present with sudden onset of chills and flu-like sxs for 1-3 weeks after arthropod bite, then rash and meningeal problems occur, death from vascular collapse or bacterial pneumonia**

Front 42

Rickettisal rash (tic) starts on the hands and feet
Typhus rash starts on the trunk and spreads outward sparing the palms and soles

Back 42

FA

Front 43

What are the vectors and reservoirs for the following:
Epidemic typhus
Endemic typhus
Scrub typhus

Back 43

R. prowazekii - lice, flying squirrels
R. typhus - fleas, rats
R. tsutsugamushi - mites, rodents

Front 44

How does ehrlichiosis present, what is the vector, and what disease family is it in?

Back 44

Headache, muscle aches, and fatigue (flu-like sxs), can also kill and infect WBC leading to opportunistic infections (candidiasis)
tic vector (highest incidence in spring and summer)
Rickettsial diseases

Front 45

All these lovelies are caused by:
non-gonococcal urethritis may progress to epidymitis or prostatitis
Cervicitis
PID
Lymphogranuloma venereum
Trachoma
Neonatal inclusion conjunctivitis
Conjunctivitis
Reiter's syndrome

Back 45

Chlamydia trachomatis

Front 46

Obvious hoe presents with painless papule on her hoe cooch that ulcerated and healed without incident. 2 months later she presents with swollen lymph nodes.

Back 46

Lymphogranuloma venereum

Front 47

Blindness that develops over 10-15 years from chronic conjunctivitis . Endemic to Africa and Asia

Back 47

Trachoma

Front 48

Drugs of choice:
chlamydial conjunctivitis
neonatal inclusion conjunctivitis
trachoma
chlamydial infection of genital tract

Back 48

dox
erythro
azithro
azithro or dox

Front 49

Standard of practice when pt presents with chlamydia infection

Back 49

assume they are concomitantly infected with gonorrhea, until ruled out by testing
Conversely, all cases of gonorrhea must be treated for chlamydial infection concomitantly

Front 50

Organism that causes Yaws (ulcerative lesions at site of infection, initial ulcers persist with additional widespread lesions + granulomas. Gummas of skin and bone)

Back 50

Treponema pertenue
Yaws - found in humid tropical areas

Front 51

Treponema pallidum subspecies endemicum causes "Bejel" endemic syphilis that presents like Yaws, but found in the middle east and Africa

Back 51

truth

Front 52

Presents like Yaws, except the lesions are red and eventually turn blue. There are no gummas in tertiary stage, instead the skin depigments. Pt hx to Rural Central America and South America

Back 52

Treponema carateum (Pinta)

Front 53

Pt presents with fever, drenching sweats, rash, and splenomegaly. Pt reports these same sxs presented about a week ago and have been remitted until today. Cause? Vector? Reason for lapse in sxs? Blood smear?

Back 53

Borrelia recurrentis
Vector is Lice
Reservoir are wild rodents in the Western US
visualize large SPIROCHETES (don't confuse with treponema nukka)
relapses d/t antigenic variation

Front 54

Pt presents with high spiking fever, headache, red eyes, and severe muscle aches in the lower back and thighs. You refuse to treat her because she smells like a sewer. She returns later with recurrence of sxs and signs of meningitis, but CSF is normal. Where does the causative organism reside? tx?

Back 54

This is Leptospirosis d/t infection with Leptospira interrogans
She was most likely swimming in a sewer or water contaminated with small animal piss. Shes a keeper.

**Weil's disease is exactly the same presentation + liver damage with jaundice, hemoptysis, and uremia with renal failure**

Front 55

Organism that causes Yaws (ulcerative lesions at site of infection, initial ulcers persist with additional widespread lesions + granulomas. Gummas of skin and bone)

Back 55

Treponema pertenue
Yaws - found in humid tropical areas

Front 56

Treponema pallidum subspecies endemicum causes "Bejel" endemic syphilis that presents like Yaws, but found in the middle east and Africa

Back 56

truth

Front 57

Presents like Yaws, except the lesions are red and eventually turn blue. There are no gummas in tertiary stage, instead the skin depigments. Pt hx to Rural Central America and South America

Back 57

Treponema carateum (Pinta)

Front 58

Pt presents with fever, drenching sweats, rash, and splenomegaly. Pt reports these same sxs presented about a week ago and have been remitted until today. Cause? Vector? Reason for lapse in sxs? Blood smear?

Back 58

Borrelia recurrentis
Vector is Lice
Reservoir are wild rodents in the Western US
visualize large SPIROCHETES (don't confuse with treponema nukka)
relapses d/t antigenic variation

Front 59

Pt presents with high spiking fever, headache, red eyes, and severe muscle aches in the lower back and thighs. You refuse to treat her because she smells like a sewer. She returns later with recurrence of sxs and signs of meningitis, but CSF is normal. Where does the causative organism reside? tx?

Back 59

This is Leptospirosis d/t infection with Leptospira interrogans
She was most likely swimming in a sewer or water contaminated with small animal piss. Shes a keeper.

**Weil's disease is exactly the same presentation + liver damage with jaundice, hemoptysis, and uremia with renal failure**

Front 60

Abrupt fever, headache, chills. Rash starts on the extremities and spreads to trunk. Produces acute vasculitis, shock, and thrombosis. Highest incidence in WV. What is the vector and agent?

Back 60

Dog Tick (reservoir is dogs and rodents)
Rickettsia Rickettsiae (RMSF)

Front 61

pt presents with fever, chills, and pneumonitis WITHOUT RASH. Produces atypical pneumonia with hepatitis. Transmitted by inhalation of what from cattle?

Back 61

Coxiella burnetti

Front 62

Sxs of chills, headache, and SEVERE BONE PAIN, and rash begin 2-4 weeks after bite from lice. Infections in d/t inhalation of lice poo. Usually self limited and seen in alcoholic homeless and IV drug abusers

Back 62

Bartonella/rochalimaea quintana

Front 63

Explain how a Weil-Felix test works to identify infection with rickettsial organisms

Back 63

Patients serum containing anti-rickettsial abs is mixed with Proteus vulgaris. A positive test agglutinates bc proteus and rickettsial species share molecular O antigen similarity

Front 64

Stimulation of ß, H2 receptors increases cellular concentration of what

Back 64

cAMP

Front 65

Stimulation of α2, M2, M4 receptors decrease the cellular concentration of what

Back 65

↓cAMP

Front 66

NO, ANP, Viagra increase the concentration of

Back 66

cGMP↑

Front 67

Stimulation of α1, M1, M3, H1, and angiotensin receptors and tachykinins and endothelin all increase the cellular concentration of what

Back 67

IP3, DAG

Front 68

Insulin and growth factors utilize what type of cellular signaling?

Back 68

tyrosine kinase

Front 69

Activation of each of the following produce what effect?
Gi
Gs
Gq

Back 69

Inhibits adenylate cyclase
stimulates adenylate cyclase
activates phospholipase C

Front 70

Rank the following nerve fibers from the largest diameter/highest velocity to the smallest diameter/low velocity:
C
Aß, Aδ
Aα
Aγ
B, C

Back 70

Aα
output to skeletal mm
input from muscle spindle
Aγ - output to muscle spindle
Aß, Aδ - sensory touch receptors (fast sharp pain)
C - sensory slow, dull pain
B,C - efferent autonomic nerves

Front 71

The DC/ML pathway travels in the dorsal columns and transmits what kind of stimuli via which receptors?

Back 71

DC/ML transmits fine touch and vibration from:
Merkel cells - pressure, slow adapting
Meissner's corpuscle - fine touch, hair follicle sensors
Pacician corpuscle - vibration, rapidly addapts

Front 72

The spinothalamic pathway carries what sensory information from which receptors?

Back 72

Spinothalamic pathway carries pain and temperature information using:
mostly free nerve endings (pain and temp)

Front 73

Steps in the accommodation to focus on a near object

Back 73

ciliary muscle contracts (stimulation of M3 receptors)
zonula fibers relax
lens becomes rounded
focal length short

Front 74

Steps in the accommodation to view a far object

Back 74

ciliary muscle relaxes (stimulation of ß2 receptors)
zonula fibers relax
lens becomes flat
focal length far

Front 75

pt has myopia (nearsightness, distant objects blurry), what is this d/t and correction?

Back 75

normal elasticity
focal point is too short (or eye is too long)
correct with negative lens (concave) Like me!

Front 76

Pt has hypermetropia (farsightedness, reading is blurry) what is this d/t and correction?

Back 76

normal elasticity
focal point is too far (or eye is too short)
correct with + lens (convex)

Front 77

Old person has prebyopia what is this d/t and correction?

Back 77

lens has lost elasticity
cannot shorten focal length
correct with + lens (convex), just like hypermetropia

Front 78

A patient admits to horizontal eye movement where eyes move slowly to the left and rapidly snap back to the right while looking out the window of a moving car. Type of nystagmus?

Back 78

Righ optokinetic
(named for the direction of rapid snap back)

Front 79

Pt states that when he rotates his head to the left rapidly his eyes move back and fourth against the prior left rotation

Back 79

Vestibular nystagmus

Front 80

Within the cochlea the scala media is different from the scala vestibuli and tympani. How?

Back 80

scala media = K+ rich, filled with endolymph
Vestibuli and tymphani = Na+ rich, perilymph

Front 81

How to preform the Webber-Rinne test?

Back 81

Weber - tuning fork on top of skull
Rinne - fork on mastoid (bone conductance), fork near ear (air conduction)

Front 82

Normal Weber-Rinne test

Back 82

W - equalizes on both sides
R - air>bone

Front 83

Findings in Weber-Rinne test in a pt with conduction deafness (middle ear)

Back 83

W - sound lateralization to bad ear
R - bone conduction>air

Front 84

Findings in Weber-Rinne test in a pt with nerve deafness (inner ear)

Back 84

W - sound lateralization to good ear
R - air>bone

Front 85

Pathway of SNS stimulation

Back 85

autonomic-->ACh nicotinic-->norepinephrine adrenergic

Front 86

Pathway of PNS stimulation

Back 86

autonomic-->ACh nicotinic-->ACh muscarnic

Front 87

Pathway of somatic motor nerve

Back 87

motor nerve directly to ACh nicotinic