Exam 2 Misc. Part 1

Front 1

What are complications of a patient not getting antibiotic therapy in Lyme Disease?

Back 1

Systemic symptoms, arthritis, fatigue, malaise, other

Front 2

What is the disease that causes Cat Scratch disease?

Back 2

Bartonella Henselae

Front 3

What are the 4 criteria that 3/4 must be met to diagnose Cat Scratch Fever?

Back 3

1. History of animal scratch/lesion 2. Culture of lymphatic aspirate that is neg. for other causes 3. Biopsied lymph node histology consistent with cat scratch disease 4. Serologic evidence for the causative agent

Front 4

What is the causative agent of Toxic Shock Syndrome?

Back 4

Staph Aureus

Front 5

Which population is Hepatitis A&E milder in?

Back 5

Children (often asymptomatic)

Front 6

What % recovery is expected in Hep A&E cases?

Back 6

99%

Front 7

What are the medically important serotypes of Vibrio Cholerae?

Back 7

O1 & O139

Front 8

What is the pathogenesis of Shiga Toxin?

Back 8

A-B exotoxin --> B subunit binds glycolipid, A subunit binds 28s rRNA subunit --> inhibits protein synthesis

Front 9

What is a retrovirus?

Back 9

Enveloped, positive stranded RNA virus

Front 10

What are the two known human lentiviruses? Which is more pathogenic?

Back 10

HIV-1 and HIV-2; HIV-1 is more pathogenic, HIV-1 clade B is the most common in the US.

Front 11

What is the leukemia virus we are responsible for knowing and what do they cause?

Back 11

HTLV-1; cancer

Front 12

What are the viral proteins and target cell receptor involved in binding, entry & fusion during the HIV-I replication cycle?

Back 12

GP120/gp41 interact with CD4 (primary receptor) and CCR5 or CXCR5 (co-receptors)

Front 13

What are the 4 clinical outcomes of HIV-1 infection in untreated persons?

Back 13

1. Typical progressors 2. Long term survivors 3. Rapid progressors 4. Longer-term nonprogressiors

Front 14

Genetic deficiency to what receptor confers resistance to HIV infection?

Back 14

CCR5

Front 15

Which drug has the following MOA? -binds to the first heptad-repeat (HR1) in the viral envelope glycoprotein gp41 => inhibition of gp41 conformational change thereby preventing membrane fusion of the HIV-1 virus with CD4+ cells

Back 15

Enfuvirtide (Fuzeon) (Inhibitor of Virus attachment and penetration)

Front 16

What AIDS drug is administered subcutaneously

Back 16

Enfuvirtide (Fuzeon) (Inhibitor of Virus attachment and penetration)

Front 17

Which drug has the following MOA? Thymidine analog which interferes with the HIV RNA-dependent DNA polymerase (reverse transcriptase) => inhibition of viral replication
-phosphorylated to active, tri-phosphate form after entry into the cell

Back 17

Zidovudine (Retrovir) (NRTIs)

Front 18

Which drug has the following MOA? same mechanism as NRTI’s (Thymidine analog which interferes with the HIV RNA-dependent DNA polymerase (reverse transcriptase) => inhibition of viral replication) BUT except it does NOT require intracellular phosphorylation to inhibit reverse transcriptase

Back 18

Efavirenz (Sustiva) (NNRTIs)

Front 19

What are NNRTIs metabolized by? And what are they also induced by?

Back 19

hepatic; (major substrate of CYP2B6, CYP3A4), (moderate inhibitor of CYP2C9, CYP2C19, CYP3A4) weak inducer of CYP 2B6 , strong inducer of CYP3A4

Front 20

What drug has the following MOA? competitively inhibits viral proteases => decreased availability of essential structural and enzymatic proteins required for transformation of HIV virus particles into mature infectious form

Back 20

Protease Inhibitors Atazanavir (Reyataz)

Front 21

What 2 AIDS drugs should we not use together due to hepatic issues?

Back 21

Atazanavir and Efavirenz

Front 22

What drug has the following MOA? inhibits the catalytic activity of the HIV enzyme integrase=> inhibition of viral DNA integration into human DNA following reverse transcription

Back 22

Integrase inhibitors Raltegravir (Isentress)

Front 23

What drug has the following MOA? selectively & reversibly binds the chemokine coreceptorCCR5 (C-C motif receptor 5) on human CD4+ cells => inhibition of the interaction between the human CCR5 and gp120 on the virus => inhibition of gp120 conformational changes required for HIV-1 fusion with CD4+ cells

Back 23

CCR5 Antagonists Maraviroc (Selzentry)

Front 24

What is HAART?

Back 24

Highly Active Anti-retroviral Therapy: either an NNRTI or a protease inhibitor or an integrase inhibitor ]+ [a dual-NRTI component]

Front 25

What is the name of 1st and 2nd gen. antihistamines?

Back 25

1. Diphenhydramine (benadryl) 2. Cetirizine (Zyrtec)

Front 26

What are the late-phase lipid mediators of Type 1 hypersensitivity reactions?

Back 26

Prostaglandin D2, Leukotrienes C4, D4, E4, Platelet activating factor

Front 27

What non-bacterial pathogen produces an exudate in the throat?

Back 27

Mononucleosis (Epstein-Barr virus) HHV4

Front 28

Which pathogen mainly infects B lymphocytes and certain epithelial cells of the oro and nasopharynx?

Back 28

Mononucleosis (Epstein-Barr virus) HHV4

Front 29

What disease is associated with Downey Cells/ atypical lymphocytes?

Back 29

Mononucleosis (Epstein-Barr virus) HHV4

Front 30

What is the classic triad of symptoms for EBV?

Back 30

1. Lymphadenopathy 2. Splenomegaly 3. Exudative pharyngitis/tonsilitis

Front 31

What pathogen has the following 4 names for stage of its growth cycle: Schizonts, Hypnozoites, merozite, trophozoites?

Back 31

Plasmodium (Malaria)

Front 32

Which is the most prevalent malarial pathogen? What does it cause?

Back 32

Plasmodium Vivax; Benign tertian malaria

Front 33

What are the 4 most common types of malaria?

Back 33

1. Plasmodium Vivax 2. Plasmodium Ovale 3. Plasmodium Malariae 4. Plasmodium Falciparum

Front 34

Which is most dangerous/ malignant type of malaria?

Back 34

Plasmodium Falciparum

Front 35

What are 2 complicaitons that lead to death in Plasmodium Flaciparum?

Back 35

1. Cerebral Malaria 2. Blackwater fever

Front 36

What drug interferes with metabolism & utilization of hemoglobin by parasites?

Back 36

Chloroquine

Front 37

What anti-malarial drug is associated with very vivid dreams?

Back 37

Chloroquine

Front 38

What anti-malarial drug is Contra-indicated in patients with psychiatric disturbances and epilepsy?

Back 38

Mefloquine

Front 39

What anti-malarial drug has the following MOA: Depresses O2 uptake and carb. Metabolism in parasite. Intercalates in DNA, disrupting the replication and transcription?

Back 39

Quinine

Front 40

What anti-malarial drug has adverse effects including QT prolongation and cinchonism?

Back 40

Quinine

Front 41

What anti-malarial drug has the following MOA: inhibits mitochondrial electron transport leading to inhibition of nucleic acid synthesis?

Back 41

Atovaquone

Front 42

What anti-malarial drug has the following MOA: Prodrug converted to cycloguanil --> inhibition of DHF reductase disrupting nucleotide synthesis?

Back 42

Proguanil

Front 43

What is Steven Johnson syndrome?

Back 43

When the dermis is separated from the dermis

Front 44

Which anti-malarial drug(s) has Steven Johnson syndrome as a side-effect?

Back 44

Atovaquone/Proguanil

Front 45

Which anti-malarial drug has the following MOA: disrupts mitochondria and binds to DNA?

Back 45

Primaquine

Front 46

What anti-malarial drug has hemolytic anemia as a side-effect, so testing for G6PD deficient patients is necessary?

Back 46

Primaquine

Front 47

What anti-malarial drug has the following MOA: (DHA) inhibit SR & ER Ca2+-ATPase’s => depletion of Ca2+ stores?

Back 47

Artemether-Lumefantrine

Front 48

What is the name of the state for massive depletion of mast-cell granules that lasts 72-96 hours after anaphylaxis?

Back 48

Tachyphylaxis

Front 49

What is a reaction similar to an allergy, specifically, an immune system reaction to certain medications, injected proteins used to treat immune conditions, or antiserum, the liquid part of blood that contains antibodies that help protect against infectious or poisonous substances?

Back 49

Serum Sickness

Front 50

What is an intracellular protozoan parasite infection in the US northeast and upper midwest that is also transmitted by ticks and resembles malaria?

Back 50

Babesiosis (Babesia microti)

Front 51

What disease and its causative virus are associated with pet hamsters?

Back 51

LCM (lymphocytic Choriomeningitis) LCM virus (arenaviridae viral family)

Front 52

What bacteria causes the plague?

Back 52

Yersinia pestis

Front 53

What parasite is white-tailed deer a carrier of (not lyme)?

Back 53

Erlichia and can be anaplasmosis

Front 54

What bacteria/disease is associated with flying squirrels? What is it transmitted by?

Back 54

Rickettsia prowazekii (epidemic typhus); body lice

Front 55

What diseases are associated with high fevers and can rarely be reactivated years later as Brill-Zinsser disease?

Back 55

Rickettsia diseases

Front 56

What is the most frequent cause of vertebral osteomyelitis?

Back 56

E. Coli and other enteric bacteria

Front 57

What causes 70% of arthritis in patients under the age of 40

Back 57

N. gonnohrrea

Front 58

What are the 5 types of specialized arthritis?

Back 58

1. Gonococcal 2. Lyme 2. Mycobacterial 4. Postinfectious/reactive arthritis (Reiter's syndrome) 5. Infection of prosthetic Joints

Front 59

What is the most common cause of necrotizing fascitis? (NOT the only one)

Back 59

Strep. Pyogenes (aka Strep gangrene)

Front 60

What is the most common cause of gas gangrene?

Back 60

Clostridium perfringens

Front 61

What is the name of an extrapulmonary bacterial infection from a normally respiratory related disease?

Back 61

Pott's Disease (tuberculosis, spinal osteomyelitis)

Front 62

What is the most likely causative agent of an anaerobic gas gangrene wound?

Back 62

Clostridial myonecrosis -most frequent cause is clostridium perfringens

Front 63

What is the most common toxin produced by the pathogen of gas gangrene?

Back 63

Alpha toxin which induces hemolysis produced by clostridium perfringes

Front 64

What presents with a classic presentation of Asymmetric polyarthritis, balanitis, urethritis, conjunctivitis, uveitis, oral ulcers and a rash?

Back 64

Reiter's syndrome - Chlamydia trachomatis (develops in 1% of NGU cases)

Front 65

What are the 2 most common causes of acute septic monoarthritis related to total knee replacement?

Back 65

Staph A. and Epid.

Front 66

Decrease in the size of an organ due to a decrease in the size of the cells that make up the organ as a result of a decreased number of intracellular organelles and/or an absolute decrease in the number of cells that comprise the organ itself e.g. muscle loss from a cast or cerebal loss during aging

Back 66

Atropy

Front 67

An increase in the size of cells due to increased synthesis of intracytoplasmic structural organelles resulting in increased size of the organ e.g. increase in the size of the uterus during pregnancy or increase in cardiac tissue due to hypertension

Back 67

Hypertrophy

Front 68

An increase in the number of cells resulting in an increase in the overall size of the organ e.g. female breast tissue enlargement at puberty , prostatic increase with age

Back 68

Hyperplasia

Front 69

The process whereby one adult cell type is replaced by another e.g. replacement of the glandular mucosa of the endocervix with squamous mucosa

Back 69

Metaplasia

Front 70

Pathologic calcification seen in dead or dying tissue. Serum calcium levels are normal. Tell tale sign of prior cell injury, e.g. damaged heart valves, atherosclerosis

Back 70

Dystrophic

Front 71

Pathologic calcification occurs in normal tissue as a result of hypercalcemia e.g. calcium deposits often occur in blood vessels, kidney and lungs

Back 71

Metastatic

Front 72

The preservation of cell and tissue architecture for up to several days. The “ghosts” of the pre-existing cells remain identifiable for up to several days.
–This type of necrosis is that which is seen in ischemia(deprivation of blood supply).
–Denaturation of protein predominates in this pattern of necrosis, he likened to a fried egg

Back 72

Coagulative necrosis

Front 73

Often the result of bacterial infections which result in the formation of an abscess [a localized collection of pus (necrotic cellular debris and pmn’s)]
–Enzymatic digestion of tissue predominates in this pattern of necrosis primarily as the result of the degredative action of PMN’s

Back 73

Liquefactive necrosis

Front 74

Cheese like pattern of necrosis, often results from TB infection, gross appearance is yellow-white

Back 74

caseous necrosis

Front 75

This necrosis is a focal process resulting in the death of adipose tissue often the result of injury to the pancreas which results in release of lipase and destruction of the adipocytes

Back 75

enzymatic fat necrosis

Front 76

Necrosis with a packed fibrin appearance

Back 76

Fibrinoid necrosis

Front 77

Nuclear shrinkage. The nucleus becomes a small dark ball

Back 77

pyknosis

Front 78

Fading of the nucleus

Back 78

Karyolysis

Front 79

Nucleus breaks up into little pieces (so-called nuclear dust)

Back 79

Karyorrhexis