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190 Cards in this Set
- Front
- Back
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__ is the drug of choice for treating bacillus anthracis while __ can be used for resistant strains.
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penicillin; ciprofloxacin
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The antiphagocytic capsule of B. anthracis is a __ polymer.
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D-glutamic acid
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Bacillus cereus is similar in many aspects to B. anthracis but it is an _.
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aerobe
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What are the 2 syndromes of B. cereus and where are they produced?
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diarrheal syndrome is produced in the intestine by vegetative cells; emetic syndrome is preformed in food
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What is the most common cause of traumatic eye infections?
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bacillus cereus
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__, __being central is the major toxin of clostridium perfringens.
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alpha toxin; lecithinase
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Growth of C. perfringens occurs in the __ and during __ an enterotoxin is produced.
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intentine; sporulation
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What are 3 antibiotics that promote pseudomembranous colitis? What 2 are used to treat the disease?
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clindamycin, cephalosporin, and ampicillin; vancomycin and metronidazole
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Which bacterium associated with periodontitis is absent from the edentulous mouth and is invasive?
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porphyromonas gingivalis
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__ are among the most frquently isolated bacteria in plaque?
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fusobacteria
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__ often dominates the subgingival flora of patients with necrotizing ulcerative gingivitis while __, together with __ are alos associated with NUG.
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prevotella intermedia; fusobacteria with spirochetes
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Which bacterium is associated with contaminating the hands of many health care workers? What is the proper hand cleaning method?
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C. difficile; chlorhexidine soap b/c it is resistant to alcohol
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What is the leading cause of preventable blindness?
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chlamydia thrachomatis
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What are the 4 diseases that come from the D-K forms of C. trachomatis?
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salpingitis, endometritis, pelvic inflammatory disease, and cervical cancer
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What member of the Ricketsiae is not a vector-borne pathogen and what disease does is cause?
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coxiella burnetti; Q-fever
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Postpartem fever and pelvic inflammatory disease can be cause by __.
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M. hominis
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An interaction of serum lipoprotein with circulating C. pneumonia immune complexes has been suggested to contribute to __.
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atherosclerosis
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Neonatal pneumonia and neonatal inclusion conjuctivitis is prevented by administering __ at birth.
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erythromycin eye drops
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C. burnetti grows in __ cells while Rickettsia species grow in __ cells.
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phagocytic; nonphagocytic
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__ are among the leading causes of meningitis and abscess formation.
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Gram - enterics
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The 2 enterotoxins of ETEC are heat labile toxin which is virtually identical to __ and elevates intracellular __ and heat stable toxin which elevates intracellular __.
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cholera toxin; cAMP; cGMP
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Both the Shiga and Shiga-like toxins have an affinity for the __ and result in __.
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kidney; hemolytic uremic syndrome
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The K1 capsule of E. coli contains __.
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sialic acid
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Shigella takes advantage of __ cells of the intestinal epithelium, specifically __.
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specialized; GALT
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What is the most common bacterial cause of diarrhea in industrialized countries?
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Campylobacter jejuni
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__ is a cause of swimmers ear.
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pseudomonas aeruginosa
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What is the causative agent of gastritis and vitually all gastric and duodenal ulcers?
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helicobacter pylori
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What is the reservoir for S. enteritidis? S. typhis?
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animals; humans
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Which campylobacter species has been implicated as a periodontal pathogen?
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C. rectus
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__ is a major agent of otitis media, respiratory disease, and, in young children, meningitis.
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H. influenzae
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H. influenzae infection starts as __.
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nasopharyngeal
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__ is the major pathogen of H. influenzae and the __ is the chief virulence factor.
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Serotype b; capsule
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The virulence factor of Bordatella pertussis is an __ toxin with action on __.
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ADP-ribosylating; adenylate cyclase
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What are the 2 diseases of Legionella pneumophila?
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Legionnaire's disease and Pontiac fever
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__ is relatively tolerant to chlorine and survives community water treatment.
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Legionella pneumophila
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L. pneumophila replicates in __ after inhalation.
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alveolar macrophages
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Aa is a major pathogen in __ and some __.
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localized aggressive periodontitis and some chronic periodontitis
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Aa is a common causes of what 4 problems?
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bacterial endocarditis, osteomyelitis, brain abscesses, and subcutaneous abscesses
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What are the 2 major virulence factors of Aa? Cell to cell spread is via a __-dependent process.
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leukotoxin and its ability to invade epthelial cells; microtubule
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What bacteria species can grow at refrigerator temps?
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Listeria monocytogenes
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Epidemics of which bacterium have been with contaminated dairy products, meat, and raw vegetables?
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Listeria monocytogenes
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Listeria escape the phagocytic vesicle by producing a __, specifically __.
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hemolysin; listeriolysin O
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How is Listeria monocytogenes similar to S. typhi? Shigella?
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it survives in and spreads via macrophages; it survives in and spreads cell to cell using the cell cytoskeleton
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Neisseria gonorrhea is generally limited to superficial mucosal surfaces lined with __ epithelium. What are the 5 most commonly affected sites?
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columnar; urethra, cervix, rectum, pharynx, and conjuctiva
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The __ epithelium which lines the __ is not susceptible to infection by N. gonorrhea.
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squamous; vagina
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Ocular infections of N. gonorrhea occur most commonly in __.
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newborns exposed in the birth canal
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As many as 15% of women with cervical infections of gonorrhea may develop __. The involement of the testes, fallopian tubes, or ovaries can result in __.
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pelvic inflammatory disease; sterility
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The recommended treatment for uncomplicated infection sof gonorrhea is a 3rd-generation __ or __ plus an antibiotic affective against possible coinfection of __.
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cephalosporin or fluoroquinolone; chlamydia trachomatis
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What bacterium shows antigenic and phase variation?
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N. gonorrhea
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Both N. mengitidis and N. gonorrhea are similar in staining and morphology except that N. meninigtidis has a prominent __.
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antiphagocytic polysaccharide capsule
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Name 6 bacterial causes of meningitis.
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Haemophilus influenza, E. coli, Streptococcus pneumonia, Streptococcus pyogenes, Staphylococcus aureus, and N. meningitidis
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What group of N. meningitidis has historically been the cause of epidemic meningococcal disease and still predominates in Africa?
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Group A
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The __ is the only known reservoir of N. meningitidis. Meningococci are spread via __ and transmission requires __ of infective particles.
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human nasopharynx; respiratory droplets; aspiration
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__ is the sole host and natural reservoir of Corynebacteria diptheria. The organism is harbored in the __ and __ and spreads via __ or __.
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man; nose and nasopharynx; respiratory droplets or direct contact
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Diptheria toxin inactivates protein synthesis __ by __.
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EF-2; ADP-ribosylation
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Exposure of purified diptheria toxin to __ gives and inactive toxoid that induces protective immunity.
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formalin
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__ infection is the most common form of uncomplicated gonorrheal infection in women.
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Endocervical
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A major __ protein in the outer membrane of the N. gonorrheal bacterium is thought to be the invasin that mediates penetration of a host cell.
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porin
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Meningococci attach to __ epithelial cells of the __. Attachment is mediated by __ and possibly by other outer membrane components.
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nonciliated columnar; nasopharynx; fimbriae
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The presence of serum bactericidal __ and __ is probably the most important host factor isn preventing invasive disease of mengitis.
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IgG and IgM
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__ is the drug of choice to treat meningococcemia and meningococcal meningitis. When can this antibiotic penetrate the BBB?
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penicillin; when the meninges are inflamed
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Which bacterium experiences lysogenic conversion making its toxin virulent?
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Corynebacteria diptheria
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Which bacterium is too slendered to be observed by standard microscopy and also causes syphilis?
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Treponema pallidum
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Treponema pallidum penetrates directly through the __ or through a __.
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mucous layer; skin abrasion
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The fetus is suscpetible to infection of syphilis only after which month of gestation?
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fourth
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What drugs are used to treat syphilis and to which one has resistance developed?
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Penicillin G, tetracycline, and azithromycin; azithromycin
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In the human mouth, where do most spirochetes reside?
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gingival crevice and pockets
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__ is the most common vector-borne illness in the U.S.
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lyme disease
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__ is the leading cause of death in the world from a bacterial infectious disease.
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TB
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__ is the #1 predisposing factor for MTB infection.
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HIV infection
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__ in the cell wall of MTB accounts for impermeability and resistance to antimicrobial agents, resistance to killing by acidic and alkaline compounds, and resistance to osmotic lysis.
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High lipid concentration
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The most commonly used drugs to treat TB is a combination of which 4?
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rifampin, isoniazid, pyrazinamide, and ethambutol or streptomycin
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The lipid fraction of MTBs cell wall consists of what 3 components?
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mycolic acids, cord factor, and wax-D
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During what stage of MTB infection do lymphocytes begin to infiltrate? Does tubercle formation occur?
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stage 3
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During the 3rd stage of MTB infection, T cells are activated and release cytokines such as __ that activated macrophages. What happens at this stage?
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IFN; the patients becomes tuberculin positive
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A __ response must be mounted to control an MTB infection.
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CMI
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What is the composition by weight % of fillers, binders, and modifiers of casting investment?
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fillers 60-65%, binders 30-35, modifiers 5
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Silica crystal fillers show a change in crystal structure from _ to _ form at a transition temp. The _ form has an increased volume and lower density.
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alpha to beta; beta
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The fillers of casting investments are polymorphic forms of __.
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SiO2
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The __ of __ binders will turn Au black.
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Sulfur; gyspum
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Gypsum investments are intended for ___.
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low fusing gold alloys
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High heat investments are needed for __ and other __ as well as __ alloys.
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Pt; noble metals; NiCr
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Binders must be refractory at __ degrees celsius and must tolerate alloy temps up to __ degrees celsius.
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900; 1350
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What reaction is exothermic and provides green strength for the binder?
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mixing the phosphate binder powder with water
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A common additive to phosphate investments is __.
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carbon
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__ investments are currently the most widely used investment material for PFM copings and pressed ceramics.
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Phosphate
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Why are silicate bonded investments often not used?
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they have a limited shelf life
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What type of radiographic equipment is considered medical?
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extra-oral
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Primary beam diameter is not to exceed __ cm. __ collimation is recommended. Source to skin distance should not be less than __ cm.
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7.6; rectangular; 18
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If SSD is 18 cm or more, x ray field should be containable in a circle of diameter no more than __ cm. If SSD is less than 18 cm, at any time the x ray field no more than __ cm.
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7; 6
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If there is no appropriate barrier for the dentist, how far should the operator be from the patient?
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2 meters
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All dental x rays manufactured after 1980 shall have a minimum half-value filtration layer of __ mm __ equivalent.
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1.5 mm; Al
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Leakage radiation if 1 meter circumference around the source not to exceed __ mR in one hour. Radiation emitted by a component other than the source shall no exceed __ mR in 1 hour at a distance of __ cm.
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100; 2; 5
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What type of speed film is not recommended? __ screens are used for extra-oral radiograpy.
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D-speed; rare earth
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What are 4 synonyms for "source of radiation"?
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source, target, focal spot, and anode
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The OFD should be as __ as possible to not increase magnification while the SFD should be __ rather than __.
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small; long; short
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What is the recommended SFD for paralleling technique?
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16"
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For the angular relationship, if CR is directed at right angle to object, __ results. If CR is directed at right angle to sensor, __ results.
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elongation; foreshortening
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For the bisecting angle technique, if vertical angulation is too great __ takes place and the image shifts __.
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foreshortening; occlusally
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For the bisecting angle technique, if vertical angulation is too small __ takes place and the image moves __.
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elongation; apically
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For the paralleling priniciple, if the verticle angle is too great __ occurs and the image shifts __.
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no foreshortening; occlusally
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For the paralleling priniciple, if the verticle angle is too small, __ occurs and the image shifts __.
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no elongation; apically
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__ cone is mandatory for paralleling technique due to a need for an increase in __.
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Long; SFD
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Definition and __ are synonymous in radiology. How are size of source and definition related?
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sharpness; inversely
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VA for all maxillary radiographs are always __. Do maxillary periapicals or bitewings have a greater VA?
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positive; periapicals
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Do maxillary anterior or posterior periapicals have a greater VA?
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anterior
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Increasing HA causes the image to shift __ and decreasing causes the image to shift __. Both cause overlapping.
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anteriorly; posteriorly
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What is the most common projection technique for periapicals?
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paralleling
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During the paralleling technique, if one is using a positioning instrument with no external ring, then the end of the cone should be kept within __ cm of the patient's skin.
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2
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Which inhalation anesthetic has the most metabolites? Why are the metabolites bad?
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halothane; they release halides which are damaging to the kidney
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The respiratory effects of inhalation anesthetics lead to an increase in __ with a decrease in __ which results in regular rhythmic shallow breathing. The reflex response to PaCO2 is blocked by all inhalation drugs except __.
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respiration rate; tidal volume; N2O
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What 2 inhalation anesthetics don't produce a singificant decrease in CO? Which has no CV effects?
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Isoflurane and Desflurane; N2O
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Inhalation anesthetics produce a direct depression of CV function via what 6 mechanisms?
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decrease in sympathetic outflow, adrenal catecholamine release, and Ca2+ release. There is a peripheral ganglion cascade, baroreceptor attenuation, and vagal stimulation
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What inhalation drugs are irritating?
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enflurane, isoflurane and desflurane
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What inhalation drugs cause pain relief?
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enflurane, isoflurane and N2O
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What inhalation drugs cause muscle relaxation?
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Enflurane and isoflurane
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What inhalation drugs cause loss of reflexes?
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halothane, enflurane, isoflurane, desflurane, and sevoflurane
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What inhalation drugs produces arrhythmias? Hepatic toxicity? Seizures?
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halothane; halothane and enflurane; enflurane
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List 3 special problems with N2O?
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The second gas effect, diffusional hypoxia, and its solubility.
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N2O solubility is a potential problem with air spaces such as __, __, and __.
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pneumothorax, bowel surgery, or middle ear
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What is a side effect of using additive to overcome the lipophilic nature of drugs?
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thrombophlebitis
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A prolonged effect of __ can lead to a coma.
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barbiturates
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Which IV agent acts on both the GABA and glutamate receptors?
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propofol
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Which IV agent acts on GABA receptor independent of GABA being present?
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propofol
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Which 2 IV drugs have a T1/2 elimination that increases drastically with increased exposure of patient to the drug? Which 3 show modest increase in T1/2 elimination? Which is in the middle?
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diazepam and thiopental; etomidate, propofol, and ketamine; midazolam
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Thiopental produces what effect?
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increase in HR
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Etomidate produces a neg. effect on all factors except which 3 in whihc it produces no effect?
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MAP, HR and CO
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Ketamine produces no effect on all factors except which 5 in which it produces a positive effect?
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CBF, ICP, MAP, CO, and HR
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Thiopental has an increased effect on which factor?
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HR
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Thiopental causes __.
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porphyria
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Propofol can be used as an __ but can produce the negative effect of __.
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antiemetic; propofol infusion syndrome
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Which IV drug inhibits steriodogenesis and is not used in the ICU?
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Etomidate
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What IV drug should be used as a bronchodilator for refractory asthma?
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ketamine
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What drug produces hallucination with emergence? It may require treatment with __.
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ketamine; benzodiazepine
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__ are useful where no analgesia is required?
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benzodiazepines
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Benzodiazepines are useful as an __ and produce __. What is their effect on the CV and respiratory systems when used alone? What is the specific antagonist?
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anticonvulsant and produce amnesia; minimal depressive effect; flumazenil
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__ and the synthetic __ congeners act at opiate receptors in the spinal cord and CNS.
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morphine and fentanyl
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Opiates can produce what type of effect on heart rhythm? It is via the __ or directly on SA and AV nodes.
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bradycardia; vagus
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Hypotension of opiates is secondary to __ release and and hypertension is due to __ effect and an intense pressor effect with __.
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histamine; renin-angiotensin; naloxone
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Respiratory depression from opioids can be reversed by which 2 antagonists?
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naloxone and nalmefene
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What does the overdose triad of opioid overdose consist of?
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pinpoint pupils, respiratory depression and coma
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What 2 drugs are combined to produce neurolept analgesia and what is it useful for? What does adding N2O do?
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droperidol and fentanyl; radiology, endoscopy and burn dressings; increases t1/2
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What is the active product of chloral hydrate and what are the neg side ffects?
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trichloroethanol; rnal toxicity and a carcinogen
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What is the mechanism of malignant hyperthermia? Culprits? Treatment drug?
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calcium release from sarcoplasmic reticulum; succinylcholine and all volatile anesthetics; dantrolene
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For Gracey curets, __ are used for facial-lingual of posterior teeth, __ for mesial of posterior and __ for distal of posterior.
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7-8;11-12; 13-14
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Articaine is classified as an __ but its __ link is the active part. Articaine also differs from the other local anesthetics b/c it has a __ rather than a __ ring.
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amide; ester; thiophene; benzene
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What should be given to a patient having seizures resulting from systemic toxicity of a local anesthetic?
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diazepam; succinylcholine for severe reactions
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__ such as __ have a high chance of allergy for local anesthetics. __ (__) may also produce allergy. Allergic patients such as those with asthma should use __.
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esters; procaine; preservative (sulphites); preservative-free
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Why do some esters such as procaine cause allergy?
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they are converted to PABA metabolite
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What are the short acting local anesthetics?
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procaine and chloroprocaine
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What are the intermediate acting local anesthetics?
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articaine, lidocaine, prilocaine, mepivicaine
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What are the long acting local anesthetics?
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bupivicaine, ropivicaine, tetracaine
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What 2 local anesthetics can cause methemoglobinemia? What is the antidote?
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prilocaine and benzocaine; IV methylene blue or ascorbic acid
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What is the long acting local anesthetic that is cardiotoxic?
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bupivicaine
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What are the 2 topical local anesthetics that can be used on the mouth, pharynx, larynx, trachea, esophagus or urethra? On the skin and not on mucous membranes?
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benzocaine and dyclonine; dibucaine and praxomine
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Injection technique solutions are __ and cause __. They can be neutralized with __.
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acidic; stinging; sodium bicarbonate
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What local anesthetic should be used for intravenous regional anesthesia?
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lidocaine
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For central nerve blocks __ has a __ action to inhibit __ release which reduces pain transmission. __ can also be used for this purpose.
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epinephrine; alpha 2 action; substance P; clonidine
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When collagen is exposed such as due to a wound, platelets recognize vWF via __.
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GPIb-IX-V
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What factor is the target for anticoagulant therapy?
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Factor X
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What are the factors of the common pathway?
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X, V, II, I and XIII
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__ inhibits thrombin activity. __ prevents activation of Factor X.
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Antithrombin III (more potent when bound to heparin); Protein C
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__ causes vasodilation producing the opposite effect of thromboxane and reduces platelets.
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prostocyclin
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Which clotting factor does not require gamma-carboxylation?
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Factor V
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__ is required for gamma-carboxylation of glutamic acid in factors __.
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II, VII, IX, and X
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Which clotting factors are produced in the liver?
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II, VII, IX, X and V
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What are the 2 most commonly used anticoagulation drugs? Antiplatelet drugs?
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warfarin and heparin; aspirin and triclopidine
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Which fibrinolytic drugs can be used in emergency situations?
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streptokinase, rtPA, retaplase, and ASPAC
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Low molecular weight heparins have greater _ activity but less __ activity (can't bind __ as well). They are usually used for __.
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anti-Xa; antiplatelet; thrombin; prophylaxis of DVT
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__ is a direct thrombin inhibitor found in the salivary glands of the medicinal leech. It can be used to treat __.
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hirudin; heparin induced thrombocytopenia
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How does hirudin bind to thrombin?
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irreversibly by binding to exosite 1 (fibrinogen site) and draping itself over the active site
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Coumarin competes with the __ and inhibits __ synthesis.
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Vit K epoxide reductase; Vit K
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What can be used to hasten the slot onset effects of warfarin?
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give with heparin
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What are the COX inhibitors that prevent platelet aggregation?
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aspirin, NSAIDS, and sulfinpyrazone
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__ prevents binding of AD during platelet aggregation which prevents the appearance of __.
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clopidigrel; GPIIb/IIIa receptors
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GPIIb/IIIa receptor antagonists prevent binding of fibrinogen to platelets. Which 2 drugs do this?
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epdifibitate and abciximab
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Agents that increase platelet cAMP inhibit aggregation. __ and __ stimulate adenylate cyclase and __ and __ inhibit phosphodiesterase.
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prostacyclin and NO; dipyridamole and cilostazol
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Neurofibromatosis is due to a mutation in NF1 gene that usually does what?
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switches rasGTP to ras GDP
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Cystic fibrosis i due to a 3 bases pair deltion of __.
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phenylalanine
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Tay Sachs is due to a deficiency of __ which lead to an accumulation of __.
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hexosaminadase; GM2-ganglioside
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Nieman Pick disease is due to a deficiency of __ which leads to an accumulation of __.
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sphingomyelinase; sphingomyelin
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Gaucher disease is due to a deficieincy of _ which leads to an accumulation of __.
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glucocerebrosidase; glucocerebroside
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Mucopolysaccharidoses is associated with Hurler syndrome which is due to a defieicieny of __ and Hunter syndrome which is due to a defieiciency of __ and both lead to an accumulation of __ and __.
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alpha L-iduronidase; L-iduronadate sulfatase; chondroiton and dermatan sulfate
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Cytogenic diseases are diagnosed by __.
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karyotyping
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Gametogenesis can lead to an increase or decrease in material, which is worse? Origin is usually __ and most chromosome disorders are not results of __.
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decrease; de novo; structural defects
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Cri du Chat is due to
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chromosome 5p deletion
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Trisomy 18 is also known as __ and trisomy 13 is also known as __.
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Edwards syndrome; patau synrome
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Fragile X syndrome is due to multiple repeats of __.
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CGG
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Prader WIlli is due to __.
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deletion of chromosome 15 from father
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Angelman syndrom is due to __.
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deletion of chromosome 15 from mother
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