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767 Cards in this Set
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What are the X and Y intercepts of Henderson-Hasselbach graphs?
How is Km related to affinity? What is the affect of competitive and non-competitve inhibition on Km and Vmax? |
1/vmax is plotted on the Y axis, 1/-Km is on the X axis
low Km corresponds to high affinity competitive inhibition increases Km, non-competitive decreases Vmax |
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How is the volume of distribution calculated given the amount of drug (100mg)administered and plasma levels (5ug/mL)?
What if the half-life (10h) and clearance (4L/h) of a drug are given? How is clearance calculated given rate of elimination and plasma drug concentration? |
Vd=drug given/plasma levels ANS: 20L
t1/2=(0.7*Vd)/Cl ANS: 57L CL=U*V/P |
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How is the loading dose calculated? (Css=1mg/L, F=.5 Vd=40L)
How is the maintenence dose calculated? (Css=1mg/L, F=1, Cl=1mL/min) What is the F when given IV? How is the loading dose affected by hepatic/renal dysfunction? |
Loading dose=Css*Vd/F (80mg)
Maintenance dose=Css*Cl/F (0.001mg/min) F=1 with IV, loading dose is not affected |
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What three drugs are cleared by zero order elimination?
A patient overdosed on a weak acid, what should be given? What should be done about a weak base overdose? What phase of metabolism to geriatric patients lose first? |
high dose aspirin, ethanol, phenytoin
weak acid: bicarb, weak base: ammonium chloride to trap in urine phase 1 |
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How is the therapeutic index calculated?
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LD/ED
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What type of channels are nicotininc receptors? Muscarinic?
Where is the primary location of muscarinic receptors?Where are nicotinic receptors located? What receptors are found on renal vascular sm ms? |
nicotinic are ligand gated Na/K channels, muscarininc are G-protein coupled
MUSCARINIC: parasympathetic to cardiac, sm ms, glands, nerve terminals sympathetic to nerve terminals NICOTINIC: sypathetic to ganglion, adrenal medulla, skel ms dopaminergic (D1) receptors are found in renal vascular sm ms --acts to relax |
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What type of G protein mediates alpha-2 receptors?
H1? V2? |
q, q, s
qiss and qiq 'til your siq of sqs a1a2b1b2 and M1M2M3 'til your D1D2H1 of H2V1V2 |
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Which g-protein class involves increasing the [Ca] concentration inside the cell via phospholipase C, PIP and IP3?
Which inhibits adenylate cyclase to decrease protein kinase A? Which forms DAG that leads to the formation of protein kinase C? |
Gq
Gi Gq |
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What drugs inhibits NE reuptake?
What drug inhibits the fusion of the NE transporter with the nerve terminal? What drug inhibits the uptake of NE into the NE transporter? What drug inhibits the conversion of tyrosine to DOPA? |
cocaine, TCAs
guanethidine reserpine metyrosine |
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What drug inhibits choline uptake into the presynaptic nerve?
What drug inhibits ACh uptake into the transporter in the presynaptic nerve terminal? |
hemicholinium
vesamichol |
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In the presynaptic NE terminal, what three receptors modulate NE release and in what way?
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M2: negatively
Angiotensin 2 receptor: positively alpha 2: NE in the cleft causes negative feedback inhibition |
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What is the primary use of bethanechol?
What drug is used to test for muscarinic sm ms contraction in asthmatics? What drug does not penetrate the CNS and acts to reverse NM junction blockade, urinary retention, and neurogenic ileus? |
cholinergic agonist which activates Bowell and Bladder smooth muscle (resistant to AChE)
methacholine (acetylcholine agonist) neostigmine |
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What is the treatment for cholinesterase inhibitor poisoning?
What is the antidote for atropine overdose? What 4 acetylcholine-related drugs are used for glaucoma? |
atropine with pralidoxime
physostigmine physostigmine, echothiophate, carbachol, PILOCARPINE in emergencies |
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Where are M1, M2, and M3 located?
What M1 antagonist is used for Parkinsons? What is the effect of atropine on the eye? |
M1-CNS, enteric nervous system, M2- decrease heart rate and contractility, M3-gut peristalsis, exocrine gland secretion, bladder contraction, miosis of eye
benztropine myadriasis and cycloplegia |
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What muscarinic antagonist is used in COPD and asthma?
What are the uses for methscopolamine, oxybutinin and glycopyrrolate? What two muscarinic antagonists are used in peptic ulcer treatment? |
ipratropium
reduce urgency in mild cystitis and reduce bladder spasms (competitive M1,M2,M3 antagonist) pirenzepine and propantheline |
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What two alpha agonists are used in the treatment of glaucoma by vasocontriction?
What three beta-blockers are used by decreasing aqueous humor secretion? Which glaucoma agent should not be used in closed angle glaucoma? Which agent causes browning of the iris? |
epinephrine and brimonidine
timolol, betaxolol, carteolol epinephrine latanoprost (a PGF 2alpha drug which increases aqueous outflow) |
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What are the five main symptoms of atropine overdose?
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red as a beet, hot as a hare, mad as a hatter, dry as a bone, blind as a bat (cycloplegia)
MAY ALSO CAUSE ACUTE ANGLE CLOSURE IN ELDERLY AND URINARY RETENTION IN BPH |
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What nicotinic antagonist is used to prevent vagal responses to drop in blood pressure (prevent reflex bradycardia from NE)
What are the four main SE? |
hexamethonium
severe orthostatic HTN, blurred vision, constipation, sexual dysfxn |
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What two beta-2 agonists are used to reduce premature uterine contractions?
What is the selectivity of phenylephrine and what is its uses? What drug is used to increase renal perfusion in shock, what is its selectivity? |
terbutaline and ritodrine (terbutaline adds small beta-1 activity)
phenylphrine is selective for alpha-1 more than alpha-2 and is used for nasal decongestion, vasoconstriction, pupillary dilation dopamine D1,D2>beta>alpha (inotopic and chronotropic for heart failure too) |
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What drug is only inotropic for heart failure, and is also used in cardiac stress testing? What is its selectivity?
What is the selectivity of low dose epi? high dose epi? NE? |
dobutamine, beta-1>beta-2
low dose=beta-1 high dose=no selectivity NE: alpha-1, alpha-2 > beta-1 |
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What indirect sympatheticomimentic is used for urinary incontinence, hypotension and nasal decongestion?
What are two centrally acting alpha-2 agonists and what are they primarily used for? |
ephedrine (release stored catecholamines like amphetamine)
clonidine and alpha-methyldopa are used in HTN, especially with renal disease |
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A patient with renal disease has HTN, what are two drugs that would not decrease renal blood flow?
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clonidine or alpha-methyldopa
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What are the four selective beta-2 agonists?
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Metaproterenol
Albuterol Salmeterol Terbutaline |
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A patient has a pheochromocytoma, what two drugs would be used before surgery and what receptor do they act on?
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phenoxybenzamine irreversibly inhibits the alpha- receptors NONSELECTIVE, phentolamine acts reversibly
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What are the two uses of prazosin/terazosin/doxazosin?
What receptor do they act on? What alpha-2 blocker is used in the treatment of depression? |
urinary retention in BPH and HTN
alpha one antagonists mirtazapine |
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What is two drugs (illegal and legal) may cause coronary vasospasm?
What drugs may cause cutaneous flushing? What drugs are associated with torsades? |
cocaine and sumitriptan
VANC-vanco, adenosine, niacin, ca channel blockers sotalol, quinidine (and their classmates), cisapride |
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What drugs are possible causative agents for agranulocytosis?
Aplastic anemia? Direct Coombs positive hemolytic anemia? |
CCCPM-clozapine, carbamazepine, colchicine, propylthiouracil, methimazole
NSAIDs, benzene, chloramphenicol, propylthiouracil, methimazole methyldopa |
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Hemolysis in G-6-PD deficient pts?
Patients should be monitored for pulmonary fibrosis in what three agents? What drug class has been shown to cause acute cholestatic hepatitis? |
hemolysis IS PAIN (isoniazid, sulfas, primaquine, aspirin, ibuprofen, nitrofurantoin)
bleomycin, busulfan, amiodarone macrolides |
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A patient has TB and begins treatment only to see his LFTs go up dramatically, why?
A man comes in with gynecomastia, he is on a laundry list of drugs, what may be causing his condition? A patient has drug induced massive hepatic necrosis, what is the likely cause? Bacterial? |
INH induced hepatitis
Spironolactone, digitalis, cimetidine, alcohol, ketoconazole halothane, valproic acid, acetaminophen. Amanita phalloides (i HAVA massive necrosis) |
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A patient is on glucocorticoids for 5 years and abruptly stops, what is likely to be seen?
What drug is known to cause gingival hyperplasia? What drugs may precipitate gout? |
adrenocortical insufficiency
phenytoin furorsemide, thiazides, niacin |
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What are two drugs that may cause osteoporosis?
What are three drugs that cause photosensitivity A kid ruptures a tendon and has multiple sites of cartilage damage, what class of drugs is likely at fault? |
corticosteroids, heparin
i SAT for a photo-sulfonamides, amiodarone, tetracycline floroquinolones |
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A patient has SLE-like symptoms but all Ab titers are negative, what is the possible cause?
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drug induced--hydralazine, INH, procainamide, phenytoin (it's not HIPP to have lupus)
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What causes Fanconi's syndrome (proximal tubular dysfunction)?
What two drugs may cause interstitial nephritis? Hemorrhagic cystitis? |
expired tetracycline, lead, tenofovir, congenital
NSAIDS, methicillin cyclophosphamide, ifosphamide |
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What may cause cinchronism?
Diabetes insipidus? Aside from buproprion, what drug carries a high risk of seizures? |
quinine, quinidine
litium, demeclocycline imipenem/cilastatin |
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What drugs cause a disulfiram-like reaction?
What drug may cause a mixed nephrotoxicity/neurotoxicity? Mixed nephrotoxicity/ototoxicity? |
metronidazole, cephs, procarbazine, 1st gen sulfonylureas
polymyxins AMGs, loop diuretics, cisplatin |
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Queen Barb takes Phen-phen and Refuses Greasy Carb Shakes and Alcohol, refers to what?
What are the CYP 450 inhibitors? |
CYP450 inducers (Quinidine, Barbituates, Phenytoin, Rifampin Griseofulvin, Carbamazepime, Alcohol, St. John's Wart)
INH, sulfonamides, cimetidine, ketoconazole, erythromycin, grapefruit juice I C KEGS going down |
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What 3 drugs should not be given to patients with sulfa allergies (only include those without 'sulf' in them)?
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thiazides, celecoxib, furosemide
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A woman is told to visualize a procedure before undergoing it in order to relax, what is this called?
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systematic desensitization
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A group of individuals who smoke are followed for 12 years, those who develop heart disease and those who don't are categorized. What kind of study is this?
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prospective cohort
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What stage of sleep involves variable blood pressure and penile tumescence?
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REM
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What is a Phase 1 trial?
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small number of healthy volunteers are used to assess safety, toxicity and pharmakokinetics of a drug
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What is a Phase 2 trial?
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small group of diseased pts, assess treatment efficacy, optimal dosing, adverse effects
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What is a phase 3 trial?
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large group of patients, randomized--compares new treatment to current standard of care
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What is the denominator in both incidence and prevalence?
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total population at risk (during a given time period if discussing incidence)
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In a population of 10,000 males and 10,000 females, 1 man develops prostate cancer every year. What is the incidence in the 10th year if no one is cured?
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1 in 9,990 (remove those no longer 'at risk')
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Positive predictive value depends heavily on what?
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the prevalence of the disease in the population (high prevalence correlates with high PPV)
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How is relative risk calculated?
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percent with disease in the exposed group divided by the percent with the disease in the unexposed group
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How is attributable risk calculated?
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differences in the prevalence of exposed vs the prevalence in the unexposed (e.g. prev exposed - prev unexposed)
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The precision of a test is concerned with what?
Accuracy? |
how reliable, consistent and reproducible the test is
validity or trueness of test measurements |
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How does random error effect a test?
How does a systemic error effect a test? |
reduces precision
reduced accuracy |
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What characterizes a crossover study?
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each participant acts as his own control
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Information regarding the results of a study is gathered at an innappropriate time, what is this called?
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late-look bias
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A study contains 90% Asian Americans, what kind of bias would this be?
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sampling bias
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A patient knows that Parkinson's disease is associated with a pill-rolling tremor, and so he responds in the affirmative when asked if he has a tremor, even though he doesn't. What is this called?
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recall bias
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What characterizes a positively skewed result?
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the mean is greater than the median which is greater than the mode
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What is a type 1 error?
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stating there is a difference when none exists
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In statistics, what is beta?
How is power calculated? |
beta is the probability of making a type 2 error
1-beta |
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How is the standard error of the mean calculated?
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standard deviation divided by the square root of the sample size
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How much of the sample fits within 1 standard deviation, 2, 3?
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68%, 95%, 99.7%
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What are two ways that the null hypothesis will not be rejected pertaining to confidence intervals?
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if the CI crosses zero for a mean between 2 variables or if it crosses 1 for odds ratio or relative risk
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What is the confidence interval if the mean is 4.0 the SEM is .5?
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3.0 to 5.0 (mean +/- 1.96*SEM)
[SEM=SD/sqroot(N)] |
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What test is used to check the difference between two means?
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t-test
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What checks the difference between three or more means?
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ANOVA
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What test is used to check data from two different proportions or percentages?
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Xsquared
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What are the three tiers of limiting disease on a international scale?
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prevent
detect reduce disability |
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When studying two variables statistical analysis gives an R value of .999 what does this mean?
What would be the coefficient of determination? |
very strong evidence, R values near 1 or -1 have the highest correlation
.999 * .999 |
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What bacterial infections are reportable (4)?
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shigella, salmonella, gonorrhea, syphilis
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What are the top three causes of death in the elderly?
15-24? 25-64? |
heart disease, cancer, stroke
injuries, homicide, suicide cancer, heart disease, injuries |
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What is does Medicare Part A relate to?
Part B? |
hospitals
doctors |
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A doctor withholds information that may make a patient suicidal, what is this called?
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therapeutic priviledge (exeption to informed consent)
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What is the burden of proof in malpractice?
What constitutes malpractice? |
more likely than not
physician had a duty to the patient, physician breached that duty, patient was harmed, this was due to the breach of duty |
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What if a child wants to know more about his illness?
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say nothing, the parents get to decide what information to disseminate
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What is part of the APGAR score and what differntiates 1 vs 2 points for each?
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Appearance (all pink vs. trunk pink)
Pulse (less or greater than 100) Grimace (grim vs. grim+cough) Activity (some vs active) Respiration (reg vs irreg) |
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What age group has the highest suicide rate?
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65-75yr old males
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A patient is riding a tricycle and was just potty trained, how old is she?
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3 (pee at 3, 3 wheels at 3)
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When does the Moro reflex disapear?
When does the Babinski reflex dissapear? When does stranger anxiety appear? |
3 months
12-14months 7-9months |
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At what age range does a child understand death and identify with same-sex parent?
When do children develop abstract reasoning? When do children start walking? |
6-11y
11 in girls 13 in boys 15 months |
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What are the Kubler-Ross stages of grief?
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denial, anger, bargaining, grieving, acceptance (not always in this order and may have more than 1)
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Describe the Tanner stages of development.
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1 Childhood
2 pubic hair, bigger testes, breast tissue elevation 3 curly pubic hair, increased penis length 4 increased penis width, raised areola, dark scrotal skin 5 adult with no raised areola |
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What characterizes awake individuals with eyes open on EEG?
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beta waves
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What stage of consciousness has alpha waves?
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awake with eyes closed
at night BATS Drink Blood |
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What characterizes light sleep?
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theta waves
at night BATS Drink Blook |
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During what stages do people sleep walk?
What is seen the most often on EEGs? |
3-4 (deepest NREM)
sleep spindles and K complexes characteristic of Stage 2 sleep (45% of sleep) at night BATS Drink Blood |
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What causes extraocular eye movements during REM sleep?
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paramedian pontine reticular formation/conjugate gaze center
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What drugs shorten stage 4 sleep and why is this important?
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benzos shorten stage 4 sleep which limit night terrors and sleep walking
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What is the use of imipramine in sleep?
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shortens stage 4 to treat enuresis
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What monoamine initiates REM sleep?
What shortens it? What is the principle neurotransmitter involved in REM sleep? |
5-HT in the raphe nucleus
NE AcH |
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A patients sleep episode begins with REM, what does this point to?
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narcolepsy
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How does brain O2 usage change during REM?
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increased
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Deficiency of what vitamin would cause Beri-Beri?
What is dry and wer Beri-Beri? |
deficiency of thiamin (B1)
dry: polyneuritis, symetrical ms wasting wet: high output cardiac failure (dilated), edema |
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A patient has cheilosis and corneal vascularization with angular stomatitis?
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riboflavin (B2)
FAD, vitamin B2, 2 ATP |
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What are two key ingredients in brewing up some niacin (B3)?
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tryptophan and B6
NAD, vitamin B3, 3 ATP |
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What vitamin is a constituent in CoA and fatty acid synthesis?
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B5 (pantothenic acid)
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A patient presents with convulsions and hyperirritibility with peripheral neuropathy, what vitamin is deficient? What two drugs may induce this deficiency?
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B6
INH and oral contraceptives |
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Abnormal myelin is seen in what vitamin deficiency?
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vitamin B12, due to decreased methionine or increased methylmalonic acid
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What vitamin is vital for the synthesis of nitrogenous bases in DNA and RNA?
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folate
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Antibiotics or injestion of raw eggs may cause what deficiency?
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avidIN binds biotIN
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What three reactions is biotin a cofactor in?
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pyruvate-->oxaloacetate
acetyl-CoA-->malonyl-CoA proprionyl-CoA-->methylmalonyl-CoA |
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The conversion of dopamine to NE requires what vitamin cofactor?
What enzyme? |
vitamin C
dopamine-beta-hydroxylase |
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What disease causes vitamin D excess most commonly?
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sarcoidosis
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A patient presents with increased RBC fragility and neurological dysfunction, what is the likely vitamin deficiency?
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vitamin E
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This vitamin catalyzes gamma carboxylation of glutamic acid residues?
Where is it synthesizes? What would be the clotting times in a newborn? |
vitamin K
intestinal flora increased PT, aPTT, normal bleeding time |
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What deficiency presents as decreased adult hair, hypogonadism and delayed wound healing?
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Zinc deficiency
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What is the limiting reagent in alcohol metabolism?
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NAD (2 are required)
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What causes the fatty change in alcoholic livers?
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high NADH/NAD ratio shunts pyruvate to lactate and OAA to malate, gluconeogenesis is inhibited (hypoglycemia) and fatty acid synthesis is emphasized
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What causes Kwashikor?
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a protein deficient MEAL
Malnutrition Edema Anemia Liver (fatty) |
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Which nucleic acid is formed by cysteine deamination?
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uracil
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What are the five ingredients for purine synthesis?
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mix CO2, aspartate, N10 formyl-THF, glutamine, glycine,
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What are the two ingredients for pyrimidine synthesis?
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aspartate, carbamoyl phosphate
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What is the direct precursor of pyrimidines and purines?
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purines: IMP
pyrimidines: orotate + PRPP |
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What occurs with a nonsense mutations?
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change resulting in early stop codon
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What is the difference between transition and transversion?
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Transition=purine for purine, pyrimidine for pyrimidine.
Transversion=conversion |
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What molecule prevents DNA from reannealing?
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Single Strand Binding proteins
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What type of RNA is the most abundant?
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rRNA
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What DNA repair process is mutated in XP?
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nucleotide excision repair
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What direction is protein synthesized?
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N to C
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What is the start codon?
What are the stop codons? |
AUG--codes for Met
UGA, UAA, UAG |
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To what regulator of gene expression do transcription factors bind?
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enhancer, and promotor at TATA/CAAT box
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A person arrives in the emergency room after eating death cap mushrooms, what biochemical process is affected?
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RNA polymerase 2
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What do the three types of RNA polymerase do?
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RNA poly 1: rRNA
RNA poly 2: mRNA RNA poly 3: tRNA (the order that they are used in protein synthesis) |
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If the capped and tailed DNA transcript is mRNA, what is it called before capping and tailing?
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hnRNA (only processed RNA is transported out of the nucleus)
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Where does the amino acid bind to tRNA?
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at the 3' end CCA sequence
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What enzyme checks to make sure that the tRNA is bound to the right amino acid?
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aminoacyl-tRNA synthetase
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What is the energy cost per amino acid added to an illongating protein chain?
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ATP-->AMP for tRNA aminoacylation
GTP-GDP-->loading tRNA onto ribosome GTP-GDP-->translocation |
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What are the three sites of the ribosome?
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A=where incoming Aminoacyl rRNA Arrives
P=accomodates growing Peptide E= holds Empty tRNA as it Exits |
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What is the removal of N or C-terminal propeptides from zymogens to generate mature proteins called?
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trimming
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Where does Rb and p53 act in the cell cycle?
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between G1 and S
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Which cells are always in G0, which cells are never in G0?
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permanent cells are always in G0, labile cells are never in G0
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Where is the site of N-linked oligosaccaride addition to proteins?
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rER
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What does COP1 and COP2 signal?
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COP1: retrograde (golgi to ER)
COP2: anterograde (ER to golgi) |
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What five drugs act on microtubules?
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mebendazole, paclitaxel, griseofulvin, vincristine/vinblastin, colchicine
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What is an ATPase that links peripheral doublets and causes bending of cilium by differential binding of doublets?
In what condition is this mutated? |
dynein
Kartagener's syndrome |
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What is a major component of RBC membranes, myelin, bile, and surfactant and is used in cholesterol esterification?
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phosphatidyl choline
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A tissue stains strongly for vimentin, what type of tissue is this?
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connective tissue
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What is the biochemical function on Ouabain?
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inhibits binding to the K+ site
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Where is the site of types 1-4 collagen?
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1= bONE, skin, tendons, dentin, fascia, cornea, wound repair
2=carTWOlege, vitreous body, nucleus pulposis 3=reticulin in skin, blood vessels, uterus, fetal tissue, granulation tissue 4=under the floor (basement membranes and basal lamina) |
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What causes the blue sclera in osteogenesis imperfecta?
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translucency of the connective tissue over the choroid
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What is the biochemical basis for alpha-1-antitrypsin induced emphysema?
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alpha-1-antitrypsin inhibits elastase
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What three processes occur both inside and outside the mitochondria?
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heme synthesis, urea cycle, gluconeogenesis
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What is rate limiting in heme synthesis?
Urea cycle? Ketogenesis? Fatty acid oxidation? |
ALA synthetase
Carbamoyl phosphate synthetase 1 HMG-CoA synthetase carnitene acyl transferase 1 |
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What is the rate limiting step in Fatty acid synthesis?
HMP shunt? Glycogenolysis? Glycogen synthesis? |
acetyl-coA carboxylase
glucose-6-P-deH glycogen phosphorylase glycogen synthase |
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What is the rate limiting step in the TCA cylce?
Gluconeogenesis? Glycolysis? De novo pyramidine synthesis? Purine? |
isocitrate dehydrogenase
fructose-1,6-bisphosphatase PFK-1 aspartate transcarbamylase, glutamine-PRPP amidotransferase |
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What is the main product of the pentose phosphate shunt and what is it used for?
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NADPH is used for anabolic processes, respiratory bursts and the p-450 system
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What does a deficiency in NADPH oxidase cause?
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chronic granulomatous disease
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What is the difference between hexokinase and glucokinase?
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hexokinase is found everywhere, has a high affinity and low capacity for glucose and is feedback inhibiteed by glucose-6-P
glucokinase is found only in the liver and pancreatic beta cells, has a low affinity and high capacity for glucose and is not feedback inhibited |
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What does a glycolytic enzyme deficiency demonstrate as?
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hemolytic anemia (usually a malfunctioning pyruvate kinase)
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What stage of glycolysis does citrate inhibit?
Alanine? Acetyl-CoA and NADH? |
PFK-1
Pyruvate kinase (Phosphoenol pyruvate to pyruvate) Pyruvate dehydrogenase (pyruvate to acetyl-CoA |
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What is the biochemical mechanism of arsenics pathology?
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inhibits lipoic acid (a required cofactor for pyruvate dehydrogenase)
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What activates pyruvate dehydrogenase?
What are the 5 required cofactors? What is the reaction? |
EXERCISE (high NAD/NADH ratio, high ADP, high Ca)
B1 (Thiamine pyrophosphate), B2, B3, B5 (CoA), lipoic acid NAD+CoA+pyruvate-->NADH+CO2+acetyl CoA |
|
|
Why would you want to convert pyruvate to alanine?
To Oxaloacetate? |
carry amino acids from liver to ms
replenish TCA cycle or gluconeogenesis |
|
|
What is the function of the Cori cycle?
|
cycle lactate from the muscles/RBCs to the liver to undergo gluconeogenesis at a cost of 4ATP
|
|
|
What 5 cofactors does alpha-ketoglutarate dehydrogenase require?
|
B1,B2,B3,B5,lipoic acid
|
|
|
What is an ATPase inhibitor in the electron transport chain?
What are some uncoupling agents? How does CN and CO inhibit ETC? |
oligomycin
2,4 DNP, aspirin, and thermogenin in brown fat all cause increased permeability=H+ leak= increased O2 consumption inhibit electron transport=decreased gradient |
|
|
What type of fatty acids cannot participate in gluconeogenesis?
|
even chain fatty acids yield only acetyl-CoA equivalents
odd chains yield proprionyl-CoA which can enter gluconeogenesis |
|
|
What gluconeogenic enzyme requires biotin and ATP?
What enzyme requires GTP? |
pyruvate carboxylase
PEP carboxykinase |
|
|
By what mechanism does and Aldolase B deficiency affect a cell?
|
Fructose-1-P builds up, limiting the amount of phosphate that can be used for glycogenolysis and gluconeogenesis
|
|
|
What comprises sucrose?
What comprises lactose? |
glucose+fructose (don't use sucrose in aldolase B def)
glucose+galactose (don't give in galactose-1-P-uridyltransferase deficiency) |
|
|
What amino acids are glucogenic?
|
His Met Arg Val (His M AR VAL ous glucose)
|
|
|
What are the acidic amino acids?
What are the basic amino acids? |
Asp, Glu
Arg, Lys (Arg, Lys are increased in histones to bind to negative DNA) |
|
|
How is ammonia cycled from muscle to the liver?
|
via alanine, which is formed when glutamate is transformed to alpha-ketoglutarate and pyruvate forms alanine
|
|
|
What is the treatment for hyperammonia levels?
|
benzoate or phenylbutyrate to lower serum ammonia levels
|
|
|
What composes the urea cycle?
|
NH4+CO2-->carbamoyl phosphate (rate limiting), this combines with ornithene to from citrulline. Next, aspartate is added to form arginosuccinate, then fumarate is given off and arginine is formed. Last, water is added, urea is released and ornithene is reconstituted
|
|
|
What forms the two nitrogen atoms and the one oxygen atom of urea?
|
Oxygen from CO2
Nitrogen from NH4 and aspartate |
|
|
What amino acid is used to from creatinine, urea and NO?
|
arginine
|
|
|
What amino acid is used to from the porphyrin ring of heme?
|
glycine
|
|
|
GABA and Glutathione are both derivatives of what amino acid?
|
glutamate
|
|
|
What are the two possible causes of phenylketonuria?
|
decreased phenylalanine hydroxylase (Phe-->Tyr) or decreased tetrahydrobiopterin cofactor
|
|
|
What is the cause of alkaptonuria?
|
homogentistic acid oxidase deficiency (in the Tyr degradtive pathway)
|
|
|
What are the three possible causes of albinism?
|
tyrosinase (DOPA -->melanin) or defective tyrosine transporters, or lack of neural crest migration
|
|
|
What is deficient in Lesch-Nyan and what builds up?
|
HGPRT (which would form IMP or GMP from guanine or hypoxanthine), uric acid builds up
|
|
|
What is deficient in patients with SCID?
|
adenosine deaminase
|
|
|
Where are GLUT-1 and -2 receptors found (non-insulin responsive)
|
1: RBCs, brain
2: kidney, liver, beta-islet cells |
|
|
Where are McArdle's effects localized?
|
muscle (no glycogen phosphorylase activity)
|
|
|
What enzyme is deficient in Von Gierke's?
|
when glucose 1 phosphate is formed from glycogen breakdown it is conveted to glucose-6-P by phosphoglucomutase and then to glucose by glucose-6-phosphatase. Glucose-6-phosphatase is deficient in Von Gierke's
|
|
|
What are the two X-linked recessive lysosomal storage diseases?
|
Fabry's and Hunter's
|
|
|
A child has hepatosplenomegaly, aseptic necrosis of the feumur and macrophages that look like crumpled tissue paper. What is the condition, def enzyme and what substrate accumulates?
|
Gaucher disease is caused by a deficient beta-glucocerebrosidase enzyme leading to the accumulation of glucocerebroside
|
|
|
A young child has peripheral neuropathy of hands/feet, angiokeratomas and cardiovascular and renal dysfunction. What is the condition, def enzyme and what substrate accumulates?
|
Fabry's disease is due to a alpha-galactosidase A deficiency leading to ceramide trihexoside accumulation
|
|
|
A small child has foam cells, cherry-red spot on macula and HEPATOSPLENOMEGALY. What is the condition, def enzyme and what substrate accumulates?
|
Nieman-Pick is a deficiency of sphingomyelinase and leads to an accumulation of sphingomyelin
|
|
|
A child has lysosomes with onion skin appearance and developmental delay/regression with a cherry red spot. What is the condition, def enzyme and what substrate accumulates?
|
Tay-Sachs, hexosaminidase A, GM2 ganglioside accumulates
|
|
|
A child has globoid cells with developmental delay and optic atrophy. What is the condition, def enzyme and what substrate accumulates?
|
Krabbe's disease is a deficiency of galactocerebrosidase leading to a galactocerebroside accumulation
|
|
|
A child has central and peripheral demyelination with ataxia and dementia. What is the condition, def enzyme and what substrate accumulates?
|
Metachromatic leukodystrophy is a deficiency of arylsulfatase 1 and results in cerebroside sulfate accumulation
|
|
|
What two deficiencies result in heparin and dermatin sulfate accumulation?
What are the two deficient enzymes? |
Hunter's and Hurler's syndrome, Hunter's is more mild without corneal clouding and with aggresive behavior
Hurler's: alpha-L-iduronidase Hunters: iduronate sulfatase |
|
|
What ketone is not measurable in the urine?
What are ketone bodies metabolized to in the brain? |
beta-hydroxybutryate
acetyl-CoA |
|
|
What process involves the carnitine shuttle?
What process involves the citrate shuttle? |
Fatty acid metabolism involves the carnitine shuttle, while FA synthesis requires the citrate shuttle
|
|
|
What accumulates in carnitene deficiency?
|
LCFAs
|
|
|
What are the essential fatty acids and the formation of what compound is especially dependent upon them?
|
linoleic and linolenic acids (and arachadonic acid if linoleic acid is absent) are required for eicosanoid synthesis
|
|
|
What is the function of hormone sensitive lipase?
What is the function of Lipoprotein lipase? |
degrade TG stored in adipocytes
LPL: degrade TG in circulating chylomicrons and VLDLs |
|
|
What is the function of lecithin-cholesterol acyltransferase(LCAT)?
What is the function of cholesterol ester transfer protein (CETP)? |
catalyzes esterification of cholesterol
mediate transfer of cholesterol esters to other lipoprotein molecules |
|
|
Whatis the function of the following apolipoproteins?
A1, B-100, C-II, B-48, E? |
A1: activate LCAT
B-100: binds LDL-R to mediate VLDL secretion C-II: cofactor for LPL B48: mediates chylomicron secretion E: mediates Extra (remnant) uptake |
|
|
What is the principle functional difference between chylomicrons and VLDL?
|
both deliver TG to peripheral tissues, chylomicrons are formed at the intestine, VLDL is formed at the liver, chylomicrons also deliver cholesterol to the liver
|
|
|
What lipoprotein mediates cholesterol movement from tissues to the liver and acts as a repository for apoC and apoE?
|
HDL
|
|
|
What are the three types of familial dyslipidemias and their root cause?
|
I: hyperchylomicronemia is due to LPL deficiency or altered C-II
IIa: hypercholesterolemia due to decreased LDL-R IV: hypertriglyceridemia du to hepatic overproduction of VLDL |
|
|
What enzymes are affected by lead poisoning and what accumulates?
|
ferrochelatase and ALA dehydratase are deficient leading to delta-ALA and coproporphyrin buildup
|
|
|
What enzyme is affected by porphyria cutanea tarda and what accumulates?
|
uroporphyrinogen decarboxylase is deficient and uroporphyrin accumulates (tea colored)
|
|
|
What enzyme is affected by acute intermittent porphyria and what accumulates?
|
porphobilinogen deaminase is deficient so porphobilinogen and delta-ALA accumulates
|
|
|
How does UV light help children with jaundice?
|
UV light converts bilirubin to urine soluable products
|
|
|
What are the two possible conformations of hemeoglobin?
What favors taut over relaxed the other? |
taut and relaxed (which has 300x the affinity for oxygen)
Cl, H+, CO2, 2,3-BPG all favor the taut form (right shift) |
|
|
How does CO2 interact with hemoglobin?
|
CO2 binds to amino acids in the N-terminus of the globin chains
|
|
|
What does the FISH laboratory technique aid in seeing?
|
microdeletions or other anomalies at the molecular level
|
|
|
In cloning, how are sites chosen for cleavage of DNA by restriction enzymes?
|
flanked by palindromic sequences (read the same either way ATCCTA)
|
|
|
What is formed when mRNA is exposed to reverse transcriptases in cloning?
|
cDNA (lacks introns)
|
|
|
What is the Sanger method of DNA sequencing?
|
Dideoxynucleotides halt DNA polymerization at each base generating sequences of varying lengths
|
|
|
Transgenic studies in mice can be either constitutive or constitutional, what is the meaning of these terms?
|
constitutive is the random insertion of a gene into the genome, constitutional is the targerted insertion or deletion through homologous recombination
|
|
|
When one gene has greater than 1 affect on one's phenotype what is this called?
What is the most common example of codominance? What is it called when a heterozygote produces a protein that prevents the normal gene from functioning? |
pleiotropy
blood groups dominant negative mutation |
|
|
What is it called when mutations at different loci can cause the same phenotype?
What is it called when there is a tendancy for two alleles to occur together more than expected by chance? What is heteroplasmy? |
locus heterogeneity
linkage disequilibrium presence of normal and mutated mtDNA causing variable expression of mitochondral disease |
|
|
Regarding Hardy Weinberg genetics, what is equivalent to the prevalence of an x-linked recessive disease in males? females?
|
males=q
females=q squared |
|
|
What is the inheritance of hyperphosphatemic rickets?
What is the inheritance of Leber's hereditary optic neuropathy? |
X-linked dominant
mitochondrial |
|
|
Where is the mutation in von Hippel-Lindau?
|
VHL (tumor supressor gene) on chromosome 3
|
|
|
Where is the mutation in NF1 and NF2?
|
17
22 |
|
|
Where is the mutation for Huntingon's disease?
|
4 (hunt 4 food)
|
|
|
Where is the mutation for Familial adenomatous polyposis?
|
the APC gene on chromosome 5
|
|
|
What is curative for hereditary spherocytosis?
What lab value is increased? |
splenectomy
MCHC |
|
|
What is the gene that is mutated in acondroplasia?
|
Fibroblast Growth Factor receptor 3
|
|
|
On what chromosome is the CFTR gene located?
What is the CFTR function in sweat glands? |
7
resorb sweat |
|
|
What are the most common X-linked recessive disorders?
|
Be Wise, Fool's GOLD Heeds False Hope
Brutons, Wiscott-Aldrich, Fragile X, G6PD def, Ocular albinism, Lesch-Nyan, Duchenne muscular dystrophy, Hemophilia A and B, Fabry's, Hunter's |
|
|
What are four diseases of trinucleotide repeats?
|
Huntington's, fragile X, myotonic dystrophy, Friedrich's ataxia
|
|
|
What special labs would point to Down syndrome?
|
increased beta-HCG, decreased alpha-fetoprotein
|
|
|
How are the hands different between Edward's and Patau?
How does maternal age correlate with chromosome abnormalities? |
Patau syndrome is associated with Polydactyly, Edwards children have clenched fists
increasing age=increasing incidence in all three |
|
|
What is the mutation in cri-du-chat?
|
congenital deletion of the short arm of chromosome 5
|
|
|
What is a pericentric and a paracentric inversion?
|
pericentric inversions involve the centromere and proceed through meiosis
|
|
|
What are the two 22q11 syndromes and what are the main symptoms?
|
velocardiofacial syndrome and DiGeorge syndrome present with varying amounts of CATCH-22
Cardiac abnormalities, Abnormal facies, Thymic Aplasia, Cardiac defects, Hypocalcemia |
|
|
Cold agglutinins are what type of immunglobulins?
|
IgM during the recovery phase from a mycoplasma infection
|
|
|
A child presents with multiple neisseria infections, what complement proteins are deficient?
|
C6-C8 (membrane attack complex)
|
|
|
What cell types are found in the paracortex?
|
T lymphocytes
|
|
|
What cell types are found in the medullary sinuses and cords of the thymus?
|
macrophages and plama cells
|
|
|
What is the mechanism by which T and B cells enter via the lymph node from the blood?
|
through high endothelial venules
|
|
|
A patient has a massive EBV infection, what part of the lymph node enlarges disproportionately?
|
paracortex
|
|
|
What is the difference between primary and secondary lymph node follicles?
|
primary follicles are dense and dormant, secondary follicles have pale central germinal centers and are active
|
|
|
To where does the lymphatics from the colon drain?
|
internal iliac nodes
|
|
|
What is the drainage of the lateral side of the dorsum of the foot?
|
popliteal nodes
|
|
|
What lymphatics collect in the right lymphatic duct?
|
right side of head and right arm
|
|
|
Macrophages in the spleen remove what type of organisms?
|
encapsulated
|
|
|
Where are B-lymphocytes found in the spleen?
|
follicles within the white pulp
|
|
|
Where are T lymphocytes found in the spleen?
|
PALS and red pulp with the RBCs
|
|
|
What pouch is the thymus derived from?
|
3rd
|
|
|
What is the embryonic derivation of lymphocytes?
|
mesenchymal (loose CT from mesoderm)
|
|
|
Where do T-lymphocytes mature?
|
at the corticomedullary junction (immature lymphocytes start in the cortex)
|
|
|
A histological section shows Hassel's corpuscles and epithelial reticular cells, where is the slice taken from?
|
medulla of thymus
|
|
|
What IL causes maturation of a helper T cell into a TH1 cell?
What cytokines do Th1 cells produce? |
IL-12
IL-2, IFN-gamma to activate macs and CD8 cells |
|
|
What IL causes maturation of a helper T cell into a TH2 cell?
What cytokines do TH2 cells produce? What cytokine inhibits TH2 differentiation? |
IL-4
IL-4, IL-5 to help B lymphocytes produce antibody (esp IgE) IFN-gamma inhibits TH2 differentiation |
|
|
Where is the antigen loaded on MHC class 1?
|
rER
|
|
|
Where is the antigen loaded on the MHC II molecule?
|
acidified endosome
|
|
|
What immune globulin mediates Type 2 (cytotoxic) and Type 3 (immune complex) hypersensitivity?
|
IgG
|
|
|
Aside from the TCR-MHCII interaction, what is the costimulatory signal for Th cell activation?
|
B7 on APC binds CD28 on Th cell
|
|
|
Aside from TCR-MHC I, what is the costimulatory signal (cytokine) involved in Tc activation?
|
IL-2
|
|
|
Aside from random VJ and VDJ (heavy chain) recombination, what are the three other means by which antibody diversity is achieved?
What enzyme is responsible for random addition of nucleotides during recombination? |
random combination of heavy and light chains, somatic hypermutation, addition of nucleotides during recombination
terminal deoxynucleotidal transferase |
|
|
Where is the C terminal of the antibody?
|
at the Fc region (base)
|
|
|
What two antibodies are expressed on mature B lymphocytes that have not undergone isotype switching?
|
IgM and IgD
|
|
|
What ligand mediates isotype switching in conjugation with cytokines?
|
CD40
|
|
|
Where does IgA pick up the secretory component from?
|
epithelial cells
|
|
|
What constitutes an Ig allotype?
What constitutes an idiotype? |
Ig epitope that differs between members of the same species
Ig epitope determined by the uniqueness of the hypervariable region (e.g. all members of an idiotype would respond to only one antigen) |
|
|
What are the two anti-inflamatory cytokines?
|
IL-10 and TGF-beta
|
|
|
What cytokines principally stimulates T cells?
|
IL-2
|
|
|
What IL stimulates bone marrow?
|
IL-3
|
|
|
What interleukin stimulates class switching to IgE and IgG?
|
IL-4
|
|
|
What interleukin stimulates IgA production?
|
IL-5
|
|
|
What IL is the major chemotactic factor for neutrophils?
|
IL-8
clean up in IL-8 |
|
|
What interleukin secreted by B cells and macrophages activates NK and Th1 cells?
|
IL-12
|
|
|
What pyogenic IL is responsible for the acute inflamatory response and is secreted by macrophages?
|
IL-1
|
|
|
What cell lineage has cell surface proteins that are receptors for Fc and C3b?
|
macrophages
|
|
|
What two complement molecules are essential for causing anaphylaxis?
What characterizes the classic and alternative pathway of complement activation? |
C3a and C5a
IgM and IgG activate complement via the classic pathway, molecules on the surface of microbes (such as endotoxins) activate complement via the alternative pathway |
|
|
In defending against bacterial infections, what two molecules are the primary opsonins?
|
IgG and C3b
|
|
|
What two molecules prevent complement activation against self-cells?
A deficiency of one of these would lead to what condition? |
Decay-accelerating factor and C1 esterase
DAF deficiency is associated with complement mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria |
|
|
What complement molecules comprise the MAC?
|
C5b-9
|
|
|
What complement molecules are important in viral neutralization?
|
C1-C4
|
|
|
A deficiency of C1 esterase causes what condition?
|
hereditary angioedema
|
|
|
What effect do interferons have on virally infected cells?
|
IF-alpha and beta degrade viral mRNA
|
|
|
A patient demonstrates a prolonged parasitic infection, what is the likely cause?
|
programmed rearrangement of antigenic substances present on trypanosomes
|
|
|
What bacteria has two flagellar varients which aids in its immune avoidance?
|
salmonella
|
|
|
How is anergy achieved?
|
T lymphocytes become nonreactive when binding to MHC without costimulatory molecule
|
|
|
What are the three components of an immune complex?
|
antigen-antibody-complement
|
|
|
Type 1 diabetes is what type of hypersensitivity?
|
type 4
|
|
|
A patient has low levels of all globulins with recurrent bacterial infections that started at 6 months of age. What is the most likely condition?
|
Bruton's agammaglobulinemia
|
|
|
Hypocalcemic tetany with recurrent viral and fungal infections?
|
DiGeorge syndrome
|
|
|
What would an IL-12 receptor deficiency present as?
|
disseminated mycobacterial infections due to a decreased Th1 response
|
|
|
What is the defect in the hyper IgM syndrome?
What type of infections would predominant? |
Defect in the CD40L on CD4 helper T cells leading to an inability to class switch.
severe pyogenic infections early in life |
|
|
A patient has pyogenic Infections, purpura and eczema, what does this triad point to?
|
Wiscott-Aldrich, an X-linked defect that rsults in the inability to mount an IgM response to capsular polysaccharides of bacteria
|
|
|
What Ig abnormalities are associated with Wiscott-Aldrich?
|
low IgM, normal IgE, high IgA
|
|
|
What are the five symptoms associated with Job's syndrome?
What is the cytokine abnormality associated with this condition? |
FATED: Facies, Abscesses (staph), retained primary Teeth, high igE, Dermatologic problems
IFN-gamma by helper T cells |
|
|
Recurrent bacterial infections WITHOUT PUS FORMATION AND DELAYED SEPERATION of the UMBILLICUS?
|
LFA-1 integrin defect causing leukocyte adhesion deficiency
|
|
|
What is the principle defect of Chedia-Higashi?
|
failure of fusion of the phagosome with the lysosome
|
|
|
What immune response prevents Candida infection? Dissemination?
|
candida infection is prevented by T cells, dissemination is prevented by neutrophils
|
|
|
A patient has a defect in DNA repair enzymes with angiomas and ataxia, what is the likely condition?
|
ataxia telangiectasia
|
|
|
A patient has normal numbers of B-cells with a plasma cell deficiency, wahat is the likely condition and age of incidence?
|
common variable immunodeficiency can show up in your 20-30s
|
|
|
What is associated with anti-Scl antibodies?
|
diffuse scleroderma
|
|
|
What is associated with anti-smooth muscle antibodies?
|
autoimmune hepatitis
|
|
|
What is associated with anti-Jo-1 antibodies?
|
polymyositis, dermatomyositis
|
|
|
What is associated with c-ANCA?
|
Wegener's granulomatosis
|
|
|
What is associated with anti-mitochondrial antibodies?
|
primary billiary cirrhosis
|
|
|
What is associated with anti-U1 RiboNuclearProtein?
|
mixed connective tissue disease
|
|
|
What 4 conditions are associated wtih HLA-B27
|
PAIR: psoriasis, ankylosing spondylitis, inflamatory bowell disease, reiter's syndrome
|
|
|
What HLA type is associated wtih Grave's disease and celiac sprue?
|
HLA B8
|
|
|
What HLA type is associated with MS, hay fever, SLE, and Goodpasture's syndrome?
|
DR2
|
|
|
DM type 1 is associated with what HLA type?
|
HLA DR3
|
|
|
DM type 1 AND Rheumatoid Arthritis are associated with what HLA haplotype?
|
DR4
|
|
|
HLA DR5 is associated with what two conditions?
|
pernicious anemia and hashimoto's thyroiditis
|
|
|
Steroid responsive neoplastic syndrome is associated with what HLA type?
|
DR7
|
|
|
What is the MOA of cyclosporin?
|
binds to cyclophillins to inhibit IL-2 production
|
|
|
What is the MOA of tacrolimus?
|
binds FK binding protein to prevent IL-2 secretion
|
|
|
What is the MOA of azithioprine?
What drug would interact to increase the toxicity? |
antimetabolite precursor of 6-mercapatopurine that interferes with metabolism and synthesis of nucleic acids
allopurinol inh. xanthine oxidase, which breaks down MP |
|
|
What drug is a monoclonal antibody that binds to the epsilon chain of CD3 on T cells?
|
muromonab-CD3
|
|
|
What drug binds to mTOR inhibiting the T cell response to IL-2?
|
sirolimus
|
|
|
What is the MOA of mycophenolate mofetil?
|
inhibits the de novo synthesis of guanine and blocks lymphocyte production
|
|
|
What drug is a monoclonal antibody with high affinity for IL-2?
|
daclizumab
|
|
|
What is the use of filgastrim?
|
G-CSF for recovery of bone marrow
|
|
|
What is the use of sargramostim?
|
GM-CSF for recovery of bone marrow
|
|
|
What are the uses of alpha interferon?
|
Hep B and C, Kaposi's, leukemias, malignant melanoma
|
|
|
What is the use of beta-interferon?
|
MS
|
|
|
What is the treatment for chronic granulomatous disease?
|
gamma-interferon
|
|
|
What two recombinant cytokines are used to treat thrombocytopenia?
|
oprelvekin (IL-11) and thrombopoietin
|
|
|
What type of transplant rejection is reversible and what drug may treat it?
|
acute rejection may be treated by cyclosporine and OKT3
|
|
|
What part of the cell wall gives gram positives their ability to induce TNF and IL-1?
|
techoic acid
|
|
|
What part of the gram negative structure induces TNF and IL-1?
|
Lipid A
|
|
|
In what part of the bacterial cell structure are anzymes found (esp. beta-lactamases)?
|
periplasmic space
|
|
|
What is unique about the capsule of bacillus anthracis?
|
contains d-glutamate
|
|
|
What structure contains dipicoinic acid and a keratin-like coat?
|
spore
|
|
|
What is unique about the cell wall of mycoplasma?
|
does not exist, only has a sterol containing cell membrane
|
|
|
What are the two unique components to gram negative bacteria cell walls?
|
periplasmic space and an LPS/endotoxin outer membrane
|
|
|
During what phase of bacterial growth are spores produced?
|
stationary phase
|
|
|
What gram positive is unique in that it has a outer cell membrane/endotoxin?
|
listeria
|
|
|
Compare the antigenicity and heat stability of exotoxin and endotoxin.
|
Exotoxins are destroyed at 60 degrees celsius (except stap enterotoxin) and have high antigenicity and toxicity
Endotoxins have low toxicity, low antigenicity and are stable at temperatures of 100 degrees celsius for 1 hour |
|
|
What three organisms secrete an IgA protease?
|
s. pneumo, h.flu, neisseria
|
|
|
What organisms use a surface protein to prevent phagocytosis?
|
group A strep have a phagocytosis preventing M protein
|
|
|
A child comes in with a scalded skin appearance that easily pulls away from the underlying tissue, what organism likely caused this and via what toxin?
|
Staph aureus giving off exfoliatin
|
|
|
What two cytokines are produced during superantigen infection?
|
IL-2 and IFN-gamma
|
|
|
What do the heat labile and heat stable toxins of ecoli cause?
|
heat labile stimulates adenylate cyclase, heat stabile stimulates guanylate cyclase (Labile like the Air, stable like the Ground)
|
|
|
What is the antigen sought in the ASO test and what does it point to?
|
streptolysin O from s.pyogenes is used to diagnose rheumatic fever
|
|
|
Describe the three parts of anthrax toxin?
|
Protective Antigen: shuttles the three components into the cell in Trojan-horse fashion
Edema Factor: activate adenylate cyclase to increase cAMP Leathal Factor:acts as a Zn2+-dependent endoprotease that snips off the N-terminus of mitogen-activated protein kinase kinases (MAPKK). This inhibits these kinases by not allowing them to efficiently bind to their substrates, which leads to altered signaling pathways and ultimately to apoptosis |
|
|
Activation of Hageman factor by endotoxin causes what?
|
DIC
|
|
|
What two complement factors are activated by endotoxin?
|
C3a (edema, hypotension) and C5a (neutrophil chemotaxis)
|
|
|
An alpha hemolytic organism is bile soluable, what is it?
|
strep pneumo
|
|
|
How are group B strep (agal) and group A strep (pyo) differentiated?
|
B-BRAS. Group B resistant, group A sensitive
|
|
|
What are the two gram negative rods that are the principle slow fermenters of lactose?
|
citrobacter, serratia
|
|
|
What organism produces a red pigment?
|
serratia marascens
|
|
|
Thayer Martin media is used for what organism?
Chocolate agar? Bordet-gengou (potato agar)? |
N. gonorrhea
h.flu bordatella pertusis |
|
|
What organisms requires a Tellurite plate with Loffler's media?
Lowenstein-Jensen agar? Charcoal yeast extract with increased iron and cysteine? |
c. diptheria
mycobacteria tuberculosis legionella |
|
|
What stain is used to detect tropheryma whippelii?
|
PAS stains glycogen(t.whippelii is a gram positive organism)
|
|
|
What does a silver stain show?
|
legionella and fungi
|
|
|
What four organisms can be seen with a Giemsa stain?
|
borrelia, plasmodium, trypanosomes, chlamydia
|
|
|
What is the term for the direct uptake of DNA from the environment by prokaryotes and eukaryotes?
|
transformation
|
|
|
What is Hfr to F- conjugation?
|
F+ plasmid is incorporated into bacterial chromosomal DNA
|
|
|
What is the difference between generalized and specialized transduction?
|
generalized transduction involves a lytic phage, specialized transduction involves a lysogenic phage both result in bacterial DNA becoming part of the viral genome
|
|
|
By what process is genetic material transferred from chromosomes to plasmids and back?
|
transposition
|
|
|
What toxins are transferred via specialized (lysogenic) transduction?
|
ABCDE: shigA-like toxin, Botulism toxin, Cholera toxin, Diptheria toxin, Erythrogenic toxin of strep pyogenes
|
|
|
What are the obligate aerobes?
|
Nocardia, pseudomonas, mycobacteria tuberculosis, bacillus (Nagging Pests Must Breath)
|
|
|
What are the obligate anaerobes?
|
Actinomyces
Bacteroides Clostridium |
|
|
What do obligate anerobes lack and what type of antibiotics are useless?
|
lack catalase and/or SOD
aminO2glycosides are ineffective because they require O2 to enter the cell |
|
|
What are the obligate intracellular bugs?
What are the faculative intracellular bacteria? |
chylamydia and rickettsia cannot produce their own ATP
Salmonella, neisseria, brucella, mycobacterium, listeria, francisella, legionella, yersinia (Some Nastly Bugs May Live FaculativeLY) |
|
|
What is the only way to get rid of spores?
What spores are found in the ground? |
autoclave
b. anthracis, clostridium perfringens, c. tetani (other spore formers: b.cereus and c.botulinum) |
|
|
What are the five ureas positive bugs?
|
h.pylori, proteus, klebsiella, ureaplasma, staph saphrophyticus
|
|
|
What are the two alpha hemolytic organisms?
|
strep pneumo and strep viridans
|
|
|
What are the four beta-hemolytic organisms?
|
staph aureus, listeria monocytogenes, streptococcus agalactiae, strep pyogenes
|
|
|
Antibodies to what component of strep pyogenes causes rheumatic fever?
|
M protein--but also enhances host defenses
|
|
|
Strep pneumo is the most common agent in what four conditions?
|
Meningitis
Otitis media Pneumonia Sinusitis |
|
|
What agent should be implicated in sepsis in patients with sickle cell anemia and splenectomy?
|
strep pnemo
|
|
|
Growth in 6.5% NaCl points to what infectious agent?
|
enterococci
|
|
|
How does Lancfield grouping categorize types of streptococci?
|
based upon the differences in C carbohydrate
|
|
|
Where is the noramal place of colonization of strep viridans?
|
oropharynx
|
|
|
What are two causes of subacute bacterial endocaritis?
|
strep sangius (viridans) and enterococci
|
|
|
What genus of bacteria are gram positive, spore forming, obligate anerobes?
|
clostridia
|
|
|
What toxin is used to cause gas gangrene?
|
lecithinase (alpha toxin)
|
|
|
What is the toxin that diptheria produces and how is diptheria identified microscopically?
|
ADP ribosylator of EF-2 encoded by a beta-prophage
gram positive rods with metachromatic granules |
|
|
What bacteria uses actin rockets to move from cell to cell?
|
listeria monocytogenes
|
|
|
What two bacteria form long filaments which appear fungal and how do you differentiate between the two?
|
actinomyces and nocardia
actinomyces causes oral-facial abcesses, nocaria causes pulmonary infections in immunocompromised patients |
|
|
What is the treatment for Nocardia?
Actinomyces? |
Nocardia=sulfas
Actinomyces=penicillin |
|
|
A patient with neisseria meningitis develops DIC and necrotic adrenals, what is the condition called?
|
Waterhouse-Friderichsen syndrome
|
|
|
What bacteria causes epiglottitis?
|
h.flu
|
|
|
What is the treatment for those with h.flu meningitis?
What is the treatment for close contact prophylaxis? |
cephtriaxone
rifampin |
|
|
Some species of enterobacteriacae have what three antigens?
|
O- polysaccaride endotoxin
H-flagella K-capsular, corresponds to virulence |
|
|
Describe the motility of salmonella and shigella?
|
salmonella are motile and disseminate, shigella move by actin polymerization
|
|
|
What species of bacteria produce H2S?
What is the treatment? |
salmonella
let it run its course, antibiotic treatment may prolong |
|
|
What bacterial infection is known to cause pseudoapendicitis or pseudochron's?
|
yersinia enterocolitica
|
|
|
Reheated meat dishes are notorious for this bug?
What two organisms are common in seafood? |
clostridium perfringens
vibrio parahemolyticus and vibriovulnificus (can also infect wounds in contact with contaminated water or shellfish) |
|
|
What bacteria are known for their ability to grow at 42C?
|
campylobacter (ox positive too)
|
|
|
What is the only protozoa to cause bloody diarrhea?
|
entamoeba histolytica
|
|
|
What are the four cAMP inducers (regarding toxins)?
|
enterotoxigenic ecoli HL toxin, pertussis, vibrio cholera, bacillus anthracis (EF acts as adenylate cyclase, all others act via ADP ribosylating)
|
|
|
What is the difference in action between b.pertussis and v.cholera?
|
pertussis=cough=off (permanently diables Gi)
cholera=rice water diarrhea=permantly activates Ga |
|
|
What toxin promotes lymphocytosis by inhibiting chemokine receptors?
|
pertussis toxin
|
|
|
What is the treatment for legionella?
|
erythromycin
|
|
|
What agent causes otitis externa?
|
pseudomonas aeruginosa
|
|
|
What agent causes drug use and diabetic osteomyelitis as well as hot tub folliculitis?
|
pseudomonas aeruginosa
|
|
|
What is the teatment for pseudomonas aeruginosa?
|
AMG (gentamicin) + extended spectrum penicillin (piperacillin, ticarcillin)
|
|
|
What is the treatment for H.pylori?
|
bismuth, tetracyline, metronidazole
|
|
|
What organism is often found in unpasteurized milk and what does it cause?
|
brucella (unpasteurized milk gives undulant fever)
|
|
|
What is the transmissive agent in franciscella tularensis?
Yersinia pestis? |
tick
flea |
|
|
What is the treatment for gardnerella vaginalis?
|
metronidazole
|
|
|
What are four scenarios by which one might have TB but not show it on a PPD test?
|
anergy: sarcoid, immunocompromise, malnutrition, steroids
|
|
|
Where is primary and secondary tuberculosis often localized?
|
primary: hilar nodes and lower lobe Ghon complex
secondary: upper lobe and fibrocavitary lesion |
|
|
What are the two broad causes of 2ndary TB?
|
reactivation or reinfection
|
|
|
A patient with TB develops a lesion on their vertebrae, what is this condition called?
|
Pott's disease
|
|
|
An armadillo wrangler develops peripheral neuropathy with loss of eyebrows and lumpy earlobes, what are the two possible types of this disease?
|
leprosy may be either lepromatous or tuberculoid (lepromatous is lethal)
|
|
|
What is the treatment for leprosy?
|
long term dapsone or dap + rifampin and clofazimime
|
|
|
What two things does rickettsiae require from its host in order to survive?
What is the treatment for ricketsial infection? |
CoA and NAD
tetracycline |
|
|
What is the only type of ricketsia that is transmitted by aerosol and causes pneumonia?
What type is from fleas and causes endemic typhus? What kind is from a human body louse and causes epidemics? |
coxiella
r. typhi r.prowazekii |
|
|
What is the difference between r.typhi rash and r.rickettsia rash?
|
r.ricketsia starts on the WRISTS and goes to the TRUNK, typhi starts on the TRUNK and goes to the WRISTS
|
|
|
Negative Weil-felix points to what organism and disease?
Positive? |
Q fever from coxiella burnetii
r.rickettsia and r.typhi |
|
|
What virus causes a rash on palms and soles?
|
cocksakie A virus
|
|
|
What is the function of the elementary body phase of chlamydia and the reticulate body phase?
|
elementary enters, reticulate replicates
|
|
|
What is unusual about the chlamydial cell wall?
|
lacks muramic acid
|
|
|
What is the only type of chlamydia that has an avian resorvoir?
|
chlamydia psittaci
|
|
|
What do chlamydia types A-C do?
L1-L3? D-K? |
African Blindness and Chronic infection?
lyphogranuloma venerum everything else |
|
|
What are the three spirochetes?
What is the only type visible with aneline dyes? |
borrelia, leptospira and treponema
borrelia |
|
|
A patient has azotemia, severe jaundice, fever, hemorrhage and anemia. What bacteria might have caused this?
|
leptospira interrogans causing Weil's disease
|
|
|
How does borrelia burgdorferi get from deer to humans?
|
via Ixodes tick (which also transmits Babesia
|
|
|
What is the treatment for Lyme disease?
|
doxycycline
|
|
|
What are the three stages of Lyme disease?
|
Stage 1: erythema chronicum migrans
Stage 2: neurologic and cardiac manifestations Stage 3: chronic monoarthritis and migratory polyarthritis |
|
|
What characterizes 2ndary and tertiary syphillis?
|
2:maculopapular rash, condylomata lata
3: gummas (liver granuloma), neurosphilis, argyll-robertson pupil |
|
|
A child is born with saber shins, CN VIII deafness, and Huctchinson's teeth, what is the likely cause?
|
congenital syphillis
|
|
|
Bell's palsy is most often associated with what infectious agent?
|
borrelia burgdorferi
|
|
|
What things may cause false positives on the VDRL test?
|
Viruses
Drugs Rheumatic fever Lupus and leprosy |
|
|
I am produced by histoplasmosis and coccidiomycoses, I am asexual, what am I?
|
conidia (spores)
|
|
|
What does candida produce at 37C and 20C?
|
pseudohyphae at 20C, germ tubes at 37C
|
|
|
I am the only bacteria that has cholesterol in my membrane?
|
mycoplasma pneumonia
|
|
|
I am big, broad based, and budding yeast?
|
Blastomycosis
|
|
|
What is similar between histoplasmosis, blastomcosis, coccidiomycosis, and paracoccidiomycosis?
|
(cold=mold, heat=yeast)
|
|
|
A person who spent the past year in rural guatemala returns with captain wheel yeast?
|
paracoccidiomycosis
|
|
|
What yeast is treated with selenium sulfide and miconazole?
|
tinea versicolor
|
|
|
What 3 agents may be responsible for pruritic lesions with central clearing?
Which has a pet resorvoir? |
microsporum, trichophyton, epidermophyton
micosporum |
|
|
On KOH prep what would you see in a tinea scraping?
|
mold formation (not dimorphic)
|
|
|
What does a methenamine silver stain of lung tissue that gives a positive result point to?
What is the treatment? |
pneumocystis jiroveci
TMP/SMX dapsone, pentamidine |
|
|
I am a cigar shaped budding yeast, I am monomorphic and I live on vegetation?
What is the treatment? |
sporthrinx schenckii
itraconazole or potassium iodide |
|
|
What is the treatment for african sleeping sickness in CNS and blood borne?
|
CNS=melarsoprol
Blood=suramin |
|
|
What is the treatment for Chagas?
What is the vector? |
trpanosoma cruzi infects humans via the Reduviid bug and is treated with nitrofurtimox
|
|
|
A patient has macrophages containing amastigotes, what condition does he have and how is this treated?
|
leishmania donovani is treated wtih sodium stibogluconate
|
|
|
What protozoa has both maltese cross and ring forms and how is it treated?
|
babesia is treated with quinine and clindamycin
|
|
|
What agent causes mild diahhrea in immunocompetent but severe diarrhea in AIDS patients?
|
cryptosporidium parvum
|
|
|
What agent causes bloody diarrhea, liver abcesses and shows RBCs within amoebas on blood smear?
What is the treatment? |
entamoeba histolytica
metronidazole and iodoquinol |
|
|
What is the primary treatment for pinworm, roundworm and hookworm?
|
mebendazole or pyrantel pamoate
|
|
|
What three helminths may enter the body through the skin?
|
strongyloides stercoralis, ancyclostoma duodenale, and necator americanus (the latter two are hookworms)
|
|
|
What helminth may enter the body through eggs found in undercooked meat and cause granuloma formation and blindness (if gran in eye) and visceral larva migrans?
What is the treatment? |
toxocara canis is treated with diethylcarbamazine
|
|
|
A woman comes in with elphantiasis (blocked lymph channels). It is later discovered that the vector was a female mosquito. What helminth is the likely agent and how is it treated?
|
wuchereria bancrofti is treated with diethylcarbamazine
|
|
|
A patient enters presenting with eye pain, you can see something crawling under the conjunctiva, what is the likely agent and how is it treated?
|
loa loa is treated with diethylcarbamazine
|
|
|
Which Hep viruses have a lipid envelop and what is the significance of this?
|
B,C,D are susceptible to bile acids
|
|
|
What is the genome of the hep viruses?
|
A: ss+RNA
B: dsDNA C: ss+RNA D: ss-RNA E: ss+RNA |
|
|
What agent causes river blindness with lizard skin?
How is it treated? What causes an allergic reaction in some individuals? |
onchocerca volvulus
ivermectin microfilaria |
|
|
What helminth is picked up in contaminated drinking water and how is it treated?
|
dracunculus medinesis is treated wtih niridazole
|
|
|
Eggs in dog feces may cause this helminthic infection. How is it treated?
|
echinococcus granulosus is treated with albendazole
|
|
|
What helminth infection may give a swiss-cheese appearance to the brain and how is it treated (intestinal or neurocysticercosis)?
|
taenia solium
intestinal: praziquantel neuro: albendazole |
|
|
What helminth infection causes inflamatoin of teh muscle and what is the treatment?
|
trichinella spiralis is treated with thiabendazole
|
|
|
What are the three flukes and how are they treated?
|
schistosoma, clonorchis sinesis, paragonismus westermani are all treated with praziquantel
|
|
|
What is the host/method of transmission for schistosoma, clonorchis sinensis, and paragonimus westermani?
|
schisto: snails
clonorchis: undercooked fish paragonimus: undercooked crab meat |
|
|
What are the three nematodes that enter through undercooked foods?
|
enterobius, trichinella, ascaris
|
|
|
What parasite causes: brain cysts with seizures?
|
taenia solium
|
|
|
What parasite causes: liver cysts?
|
echinococcus granulosus
|
|
|
What parasite causes: B12 def?
|
diphyllobothrium latum
|
|
|
What parasite causes:billiary tract disease?
|
clonorchis sinensis
|
|
|
What parasite causes:hemoptysis?
|
paragonium westermani
|
|
|
What parasite causes: portal HTN?
|
schistosoma mansoni
|
|
|
What parasite causes:hematuria and bladder cancer?
|
schistosoma haematobium
|
|
|
What parasites cause: microcytic anemia?
|
ancylostoma, necator
|
|
|
What parasite causes:perianal pruritis?
|
enterobius (pinworm)
|
|
|
A child is born with low birth weight, microcephaly, seizures, petechial rash similar to the "blueberry muffin" rash of congenital rubella syndrome, and moderate hepatosplenomegaly (with jaundice), what is the likely cause?
|
congenital CMV
|
|
|
What is the only single stranded DNA virus family?
|
parvovirus
|
|
|
What are the three circular DNA viruses?
|
papilloma, polyoma, hepadnavirus
|
|
|
What is the only dsRNA virus family?
|
reoviridae
|
|
|
What are the naked (nonenveloped) viruses?
Where do they aquire their coat from? |
Naked CPR and PAPP smear: calicivirus, picornavirus, reovirus, parvovirus, adenovirus, papilloma, polyoma
all (except herpesviruses) from cell membrane |
|
|
What is the only virus type which takes its coat from the nuclear membrane?
|
herpesviruses
|
|
|
What is the only diploid virus?
|
retroviruses which have identical ssRNA molecules
|
|
|
What is the only DNA virus to replicate in the cytoplasm?
What are the only RNA viruses to replicate in the nucleus? |
poxvirus
influenza and retroviruses |
|
|
Herpesvirus
NAME THAT STRUCTURE! |
DNA enveloped virus
|
|
|
HBV
NAME THAT STRUCTURE! |
DNA enveloped virus
|
|
|
Smallpox virus
NAME THAT STRUCTURE! |
DNA enveloped virus
|
|
|
Adenovirus
NAME THAT STRUCTURE! |
DNA nucleocapsid virus
|
|
|
Papilloma virus
NAME THAT STRUCTURE! |
DNA nucleocapsid virus
|
|
|
Parvovirus
NAME THAT STRUCTURE! |
DNA nucleocapsid virus
|
|
|
Influenza/parainfluenza
NAME THAT STRUCTURE! |
RNA enveloped virus
|
|
|
Measles, mumps, rubella
NAME THAT STRUCTURE! |
RNA enveloped virus
|
|
|
RSV, HTLV, HIV
NAME THAT STRUCTURE! |
RNA enveloped virus
|
|
|
Rabies virus
NAME THAT STRUCTURE! |
RNA enveloped virus
|
|
|
Enterovirus (polio, cosakie, echo, HAV), rhinovirus, reovirus (rotavirus)
NAME THAT STRUCTURE! |
RNA nucleocapsid virus
|
|
|
What is the only non-icosahedral DNA virus?
|
poxvirus
|
|
|
What virus is the cause of roseola?
|
HHV-6
|
|
|
What virus causes conjunctivitis (pink eye) and febrile pharyngitis?
|
adenovirus
|
|
|
A patient with HIV develops progressive multifocal leukoencephalopathy, what is the causative agent and its viral class?
|
JC virus in the polyomavirus
|
|
|
This is the largest DNA virus. It is double stranded and linear. What are the three most common viruses in its viral family?
|
Poxvirus: small pox, vaccinia (milkmaid blisters), molluscum contagiosum
|
|
|
HCV, West Nile, Yellow fever, Dengue, and St. Louis encephalitis are all members of this viral family?
|
Flaviviruses with +ssRNA
|
|
|
What are the viral families that can use their own genome as mRNA?
|
These Fellows Can Punch Copies of Rna: Toga, Flavi, Calici, Picorna, Corona, Retro
|
|
|
What virus is the number one cause of fatal diarrhea in children?
|
rotavirus
|
|
|
What converts -sense RNA to mRNA to be processed by the cell?
|
RNA polymerase
|
|
|
What are the DNA viruses?
|
HHAPPPy!: Herpes, Hepadna, Adeno, Parvo, Papilloma, Polyoma, Poxvirus
|
|
|
This virus is responsible for 90% of epidemic non-bacterial outbreaks of gastroenteritis. What family is it in?
|
norovirus in the calicivirus
|
|
|
What are the two members of the family of dsRNA viruses?
|
Reoviruses: reovirus (Colorado tick fever) and rotavirus
|
|
|
What are the three members of the Togavirus family?
|
(picture a German wearing a toga while riding a horse from east and west berlin) rubella (german measles), eastern equine enchephalitis, western equine encephalitis
|
|
|
Aside from HIV, what is the other important retrovirus and what is their capsid symetry?
|
HTLV, icosahedral
|
|
|
The Coronavirus family has two important members, what are they?
|
SARS and coronavirus
|
|
|
What are the four members of the paramyoxovirus family?
|
PaRaMyxovirus: parainfluenza (croup), RSV, Measles (rubeola), Mumps
|
|
|
Ebola an Marburg are in this viral family.
|
Filovirus, -ssRNA
|
|
|
Lymphocytic choriomenigitis and Lassa fever both result from viruses in this family.
|
Arenaviruses
|
|
|
What is the one member of Hepeviridae?
|
Hep E
|
|
|
All of the -ssRNA viruses have what capsid symetry?
|
Hepeviridae, orthomyxo, paramyxo, rhabdo, filo, arena, bunya, delta are all helical
|
|
|
What are the four Bunyaviruses?
|
California encephalitis, sandfly/rift valley fever, crimean-congo hemorrhagic fever, hantavirus (hemorrhagic fever + pneumonia)
|
|
|
What are the four killed virus vaccines?
|
RIP Always: Rabies, Influenza, salk Polio, and hAv
|
|
|
Two viruses exchange genes by crossing over of chromosomes?
|
recombination
|
|
|
What processes is the exchange of segments of genes that causes worldwide pandemics?
What are the segmented viruses? How many segments does an influenza virus have? |
reassortment
BOAR: bunya, orthomyxo, arena, reo 8 |
|
|
What is it called when a fully functioning virus fixes a malfunctioning viral segment of genome?
|
complementation
|
|
|
What are the negative sense RNA viruses?
|
Always Bring Polymerase, Or Fail Replication Horribly: Arena, Bunya, Paramyxo, Orthomyxo, Filo, Rhabdo, Hepatitis Delta
|
|
|
How is HHV-8 spread?
|
sexual contact
|
|
|
What does the Tzank test look for?
|
HSV-1,-2 or VZV associated giant cells within an opened lesion
|
|
|
What type of cells circulate abnormally with EBV infection?
|
Downy cells; abnormal CD8+ cells
|
|
|
What infection is characterized by Cowdry type A inclusion bodies?
|
HSV
|
|
|
RNA is produces one large polypeptide that is cleavved by proteases into functional proteins, what does this characterize?
|
Picornavirus
|
|
|
Aedes mosquitos transmit what virus?
|
Yellow fever virus
|
|
|
Councilman bodies, black vomit, and high fever point to what infectious agent?
|
yellow fever
|
|
|
Villous destruction with atrophy leads to decreased absorbtion of Na and water with this virus.
|
Rotavirus (fecal-oral)
|
|
|
What are the primary two treatments for influenza A and B?
|
zanamivir and oseltamivir (neuraminidase inhibitors)
|
|
|
What are the viral families of the hepatitis viruses?
|
A--picornavirus
B--hepadnavirus C--flavivirus D--delta E--hepeviridae |
|
|
After two months, people with HIV can be positively identified, what is the two test procedure?
|
ELISA to rule out, Western blot to rule in
|
|
|
During the latent phase of HIV, where does the virus replicate?
|
lymph nodes
|
|
|
Oral hairy leukoplakia is caused by what viral infection in AIDS patients?
|
EBV
|
|
|
What shape do normal prions have and how does this mutate?
|
alpha-helix to beta-sheet
|
|
|
What type of osteomyelitis are IV drug users at greater risk for developing than the general population?
|
pseudomonas aeruginosa
|
|
|
Swarming motility on agar?
|
proteus mirabilis
|
|
|
What STD is associated with rectal strictures?
|
lymphogranuloma venerum from c.trach
|
|
|
What bug is a frequent contaminent of respiratory equipment?
|
pseudomonas aeruginosa
|
|
|
What drugs specifically disrupt bacterial cell membranes?
|
polymyxins
|
|
|
What drug used to treat TB blocks mRNA synthesis?
|
rifampin
|
|
|
Where is the site of action of linezolid, clindamycin, chloramphenicol, and macrolides?
|
block protein synthesis at 50s subunit
|
|
|
Where is the site of action of the AMGs and tetracyclines?
|
30s subunit
|
|
|
What are the 6 bacteriocidal antibiotics?
|
Vancomycin, Fluoroquinolones, Penicillin, AMGs, Cephs, Metronidazole (Very Finely Proficient At Cell Murder)
|
|
|
What is naphcillins primary use and what differentiates it from the penicillins?
|
Naphcillins are too large to be inhibited by beta-lactamases and are primarily used for non resistant staph (use naph for staph, except with altered binding site)
|
|
|
What is the difference between amoxicillin and ampicillin?
|
both inactivated by penicillinases, amOxicillin has better Oral availability
|
|
|
Amox/ampicillin are principally used in what infections?
|
HELPS kill enterococci: Haemophillus, Ecoli, Listeria, Proteus, Salmonella
|
|
|
What is Ticarcillin, Carbenicillin, and Piperacillin used for?
|
Take Care of Pseudomonas
|
|
|
What is unique about 3rd gen cephs (ceftriaxone, cephtazidime, cefotaxime)?
|
BBB penetration, used to treat serious gram negative infections
|
|
|
What is cefepime's (4th gen) specialty?
|
better against pseudomonas and other gram +
|
|
|
What is the spectrum for 1st and 2nd gens cephs?
|
1: Proteus, Ecoli Klebsiella (PEK)
2: Haemophillus, Enterobacter, Neisseria, Proteus, Ecoli, Klebsiella (HEN PEK) |
|
|
What drug treats Klebsiella, Serratia and Pseudomonas, has no activity against gram +, is synergistic with AMGs, and is used for penicillin-allergic patients.
|
aztreonam
|
|
|
How does the addition of cilastin improve imipenem?
|
Cilastin decreases the renal tubular inactivation of imipenem, this is especially used in life threatening infections and enterobacter due to side effects
|
|
|
How is resistance achieved against Vanco?
|
d-ala d-ala become d-ala d-lac
|
|
|
What is neomycin's principle use?
|
pretreatment for bowell surgery (ineffective against anerobes as it requires O2 for uptake)
|
|
|
What are the bugs treated by tetracylcines?
|
VACUUM THe BedRoom: vibrio, acne, chlamydia, ureaplasma urealyticum, mycoplasma pneumonia, tularemia, h.pylori, borrelia burgdorferi, ricketsia
|
|
|
What is the use of clindamycin?
|
bacteroides fragelis, clostridium perfringens (anerobes above the diaphramn)
|
|
|
What is the primary drug for nocardia?
|
sulfonamide
|
|
|
What drug is used to treat recurrent UTIs, shigella, salmonella, pneumocystis jiroveci?
|
TMP/SMX
|
|
|
What treats anerobes below the diaphramn and protozoans?
|
metronidazol
|
|
|
What is the use of polymyxins?
|
resistant gram negatives
|
|
|
What is the treatment for vancomycin resistant enterococcus?
|
linezolid or streptogrannins
|
|
|
What anti-TB agent causes optic neuropathy (red-green color blindness)?
|
ethambutol
|
|
|
What is the prophylaxis and treatment for M.avium intracellulare?
|
azithromycin is prophylaxis, azithro, rifampin, ethambutol,streptomycin is treatment
|
|
|
What is the treatment for m.leprae?
|
dapsone, rifampin, clofazimine
|
|
|
What is the prophylaxis for m.TB?
|
INH
|
|
|
What anti-TB causes a decreased synthesis of mycolic acids?
Inhibits DNA dependent RNA polymerase? |
INH
Rifampin |
|
|
How is resistance to AMGs achieved?
Macrolides? MRSA to methicillin? |
acetylation, adenylation, phosphorlyation
methylation of rRNA near ribosome binding site altered penicillin binding protein |
|
|
What two drugs bind ergosterol?
|
amphotericin B and nystatin
|
|
|
What are the uses of nystatin?
|
swish and swallow for oral candida, topical for vagina or diaper rash
|
|
|
What drugs inhibit ergosterol synthesis?
|
azoles
|
|
|
What is the MOA of flucytosine?
|
inhibits DNA synthesis by conversion to 5-FU
|
|
|
What drug inhibits fungal cell wall synthesis?
|
caspofungin
|
|
|
What is caspofungins primary use?
|
invasive aspergillosis
|
|
|
What anti-microbial inhibits squalene epoxidase and is used to treat dermatophytoses?
|
terbafine for toes
|
|
|
What drug interferes with fungal microtubule formation and thus inhibits mitosis?
|
griseofulvin (dermatophytes)
|
|
|
What is the MOA an use of amantadine?
|
block influenza penetration/uncoating, used in Parkinson's to increase dopamine release from intact nerve terminals
|
|
|
What is the MOA of zanamivir and oseltamivir and their use?
|
inhibit influenza A and B's neuraminidase
|
|
|
Despite its severe terratogenicity, ribavirin is used to treat RSV, and chronic hep C through what mechanism?
|
inhibit guanine nucleotide synthesis by competitively inhibiting IMP dehydrogenase
|
|
|
What drug is monophosphorylated to inhibit DNA polymerase? In what three viruses does this occur?
|
Acyclovir is useful in HSV, VZV and EBV
|
|
|
What is the chief use of ganciclovir?
|
CMV (requires phosphorylation)
|
|
|
What is the MOA of foscarnet and main use?
|
foscarnet is a DNA polymerase inhibitor that is useful for CMV retinitis and acyclovir resistant HSV
|
|
|
What is the mechanism of resistance for acyclovir, ganciclovir and foscarnet?
|
A and G results from lack of thymidine kinase, G and F from DNA polymerase mutation
|
|
|
Which anti-viral is a pyrophosphate analog?
|
foscarnet
|
|
|
What are the protease inhibitors?
|
-NAVIR tease a protease (saquinavir etc.)
|
|
|
What protease inhibitor may cause thrombocytopenia?
|
indinavir
|
|
|
What are the reverse transcriptase inhibitors?
|
zidovudane, didanosine, zalcitabine, stavudine, lamivudine, abacavir (NUCLEOSIDES)
nevirapine, efavirenz, delavirdine (NON NUCLEOSIDES) Never Ever Deliver nucleosides |
|
|
What drugs can be used to reduce bone marrow suppression from reverse transcriptase inhibitors?
|
GM-CSF and erythropoetin
|
|
|
What anti-viral is a fusion inhibitor and what subunit does it bind?
|
enfuvirtide binds gp41 subunit
|
|
|
What interferon is used for hep B and C and Kaposi's sarcoma?
|
INF-alpha
|
|
|
What interferon is used in MS?
|
IFN-beta
|
|
|
What interferon is used in NADPH oxidase deficiency?
|
IFN-gamma
|
|
|
What drugs should not be used during pregnancy?
|
SAFE Moms Take Really Good Care: Sulfonamides, AMGs, Fluoroquinolones, Erythromycin, Metronidazole, Tetracyclines, Ribavirin, Griseofulvin, Chloramphenicol
erythromycin causes acute cholestatic hepatitis in moms |
|
|
What are the rule of 2s, 3s, and 4s regarding embryology?
|
2nd week: two germ layers-epiblast and hypoblast, two cavities-amniotic sac, yolk sac, two components to placenta-cyto and syncytiotrophoblast
3rd week: three germ layers-ecto, meso, endoderm 4th week: 4 limbs, 4 heart chambers |
|
|
When does the primitive streak, notochord and neural plate form?
|
Week 3
|
|
|
When is organogenesis?
|
Wk 3-8
|
|
|
When does the heart begin to beat and limb buds form?
|
week 4
|
|
|
The fetus first moves during this week?
|
week 8
|
|
|
A couple is coming in for an ultrasound to determine the sex of their child, when is the earliest they could do this?
|
10th week
|
|
|
The adenohypophysis and lens of the eye are both derived from?
|
surface ectoderm
|
|
|
What are the 12 major derivatives of neural crest cells?
|
ANS, dorsal root ganglia, melanocytes, chromaffin cells of adrenal medulla, enterochromaffin cells, pia and arachnoid, celiac ganglion, schwann cells, odontoblasts, parafollicular cells of thyroid, laryngeal cartilage, bones of the skull
|
|
|
What invaginates to form the primative streak and what does it give rise to?
|
epiblast invaginates to form the primitive streak and it gives rise to intraembryonic mesoderm and endoderm
|
|
|
What are the mesodermally derived abdominal organs?
|
spleen, adrenal cortex, kidneys
|
|
|
Dura mater, urogenital structures and bone are all derived from what tissue type?
|
mesoderm
|
|
|
What is the function of the notochord and what does it persist as in adults?
|
induces neuroectoderm formation and remains as the intervertebral disk
|
|
|
Anal atresia, cardiac defects, vertebral defects, tracheoesophageal fistula, renal defects and limb defects all result from defects in this embryonic tissue?
|
mesoderm
|
|
|
ACE inhibitors during pregnancy would cause what malformation in child?
|
renal damage
|
|
|
Cocaine during pregnancy would cause what malformation in child?
|
addiction and abnormal development
|
|
|
DES during pregnancy would cause what malformation in child?
|
vaginal clear cell carcinoma
|
|
|
Iodide during pregnancy would cause what malformation in child?
|
congenital goiter or hypothyroidism
|
|
|
Thalidomide during pregnancy would cause what malformation in child?
|
high risk for limb defects
|
|
|
Tobacco during pregnancy would cause what malformation in child?
|
preterm labor, ADHD, placental problems
|
|
|
Compare and contrast mono and dizygotic twins regarding chorion, amnion, placenta.
|
both have 2 amniotic sacs, monozygotes share a placenta and chorion
Amnion=around Chorion=close |
|
|
What layer of the placenta secretes HCG?
|
syncytiotrophoblast
|
|
|
What is the maternal component of the placenta?
|
decidua basalis
|
|
|
A typical umbillical cord has two arteries and one vein, what might a child with one artery have?
|
congenital and chromosomal abnormalities
|
|
|
What is the function of the urachus?
|
connects fetal bladder with allantois to remove nitrogenous waste
|
|
|
The bulbus cordis forms?
|
The smooth part of the left and right ventricle
|
|
|
The primitive ventricle forms?
|
The trabeculated part of teh left and right ventricle
|
|
|
The truncus arteriosus forms?
|
The ascending aorta and pulmonary trunk
|
|
|
The primitive atria forms?
|
The trabeculated left and right atria
|
|
|
The left horn of the sinus venosus forms?
|
coronary sinus
|
|
|
The right horn of the sinus venosus forms?
|
smooth part of right atrium
|
|
|
The right and left common cardinal veins form?
|
SVC
|
|
|
What is the three step process for the formation of the interventricular septum?
|
1 muscular septum forms leaving an opening called the intraventricular foramen
2 aorticopulmonary septum divides the trunchus arteriosus into aortic and pulmonary trunks 3 the aorticopulmonary septum fuses with the muscular septum to form the membranous interventricular septum |
|
|
Which part of the adult septum is fomred by the septum primum?
|
caudal, the septum secundum develops after the septum primum and remains as the cranial portion
|
|
|
What constitutes the valve of the foramen ovale?
|
septum primum
|
|
|
What chains comprise fetal hemoglobin?
|
alpha2 gamma2
|
|
|
From what period does fetal blood originate in the yolk sac?
|
3-8wk
|
|
|
From what period does hematopoeisis occur in the liver?
|
6-30wk
|
|
|
From what period does hematopoesis occur in the spleen?
|
9-28wk
|
|
|
From what period does fetal hematopoesis occur in the bone marrow?
|
28wk onward
|
|
|
What conducts blood from the umbilical vein to the IVC?
|
ductus veinosus
|
|
|
Where does most blood entering the right atria of fetal circulation pass?
|
through the foramen ovale
|
|
|
Deoxygenated blood from the SVC gets shunted to the lower body of the fetus via what route?
|
from the pulmonary artery through the ductus arteriosus
|
|
|
What closes a patent ductus and what wouldd keep it open?
|
indomethicin closes, prostaglandins would keep it open
|
|
|
The umbillical vein becomes what in the adult?
|
ligamentum teres hepatis contained in falciform ligament
|
|
|
The umbiLical arteries become what in the adult?
|
mediaL umbilical ligaments
|
|
|
The ductus arteriosus becomes what in the adult?
|
ligamentum arteriosum
|
|
|
The foramen ovale becomes what in the adult?
|
fossa ovalis
|
|
|
The ductus venosus becomes what in the adult?
|
ligamentum venosum
|
|
|
The allaNtois becomes what in the adult?
|
mediaN umbillical ligament
|
|
|
A patent allantois results in a __?
|
urachal cyst
|
|
|
What is the function of the urachus?
|
connect the bladder to the allantois
|
|
|
What is the derivative of the first aortic arch?
|
part of maxillary artery
|
|
|
What are the derivatives of the 2nd aortic arch?
|
stapedial and hyoid
|
|
|
What are the derivatives of the third aortic arch?
|
common carotid and proximal internal carotid
|
|
|
What are the derivatives from the fourth aortic arch?
|
aortic arch and proximal part of right subclavian
|
|
|
What are the derivatives of the 6th aortic arch?
|
left pulmonary arteries and ductus arteriosus
|
|
|
What are the embryonic tissues that form the clefts, arches, and pouches?
|
CAP: cleft=ectoderm, arch=mesoderm (and neural crest), pouch=endoderm
|
|
|
What nerves are derived from the first brachial arch?
|
V2 and V3
|
|
|
What nerve is derived from the second brachial arch?
|
VII
|
|
|
The Ninth Cranial Nerve is derived from what branchial arch?
|
3
|
|
|
Aside from the muscles of mastication what other 5 muscles are derived from the 1st brachial arch?
|
mylohyoid, anterior digastric, tensor tympani, tensor veli palatini, anterior 2/3 of tongue
|
|
|
The mandible, malleus, incus, and sphenomandibular ligament are all derived from Meckel's cartilage, what arch is this from?
|
first
|
|
|
The stapes, styloid process, lesser horn of hyoid and stylohyoid ligament are all derived from Reichert's cartilage from what brachial arch?
|
second
|
|
|
Aside from the muscles of facial expression, what 3 other muscles are derived from the 2nd brachial arch?
|
stapedius, stylohyoid, posterior digastric
|
|
|
What are the bone and muscle derivatives of the 3rd arch?
|
stylopharyngeus and greater horn of hyoid
|
|
|
What is the sensory innervation of the middle ear?
|
IX
|
|
|
What supplies parasympathetic fibres to the parotid gland via the otic ganglion?
|
IX
|
|
|
What receives visceral sensory fibers from the carotid bodies.
|
IX
|
|
|
The carotid sinus baroreceptors are innervated by the sinus nerve of Hering, which is a branch of?
|
IX
|
|
|
What two muscles are innervated by the XI nerve?
|
sternocleidomastoid and trapezius
|
|
|
What nerve lies on top of the carotid sheath in the neck?
|
XII
|
|
|
A lesion of the XII nerve causes the tongue to deviate to what side?
|
same side
|
|
|
What innervates the palatoglossus?
|
X
|
|
|
What is the only pharyngeal muscle not innervated by the vagus?
|
stylopharyngeus
|
|
|
What two arches form the posterior 1/3 of the tongue?
|
arches 3 and 4
|
|
|
Aside from the pharyngeal constrictors, what muscles are derived from the 4th arch?
|
cricothyroid, levator veli palatini
|
|
|
What is the only laryngeal muscle supplied by the external branch of the superior laryngeal?
|
cricothyroid
|
|
|
What is the innervation of all intrinsic laryngeal muscles except the cricothyroid?
|
recurrent laryngeal off of X
|
|
|
What muscles are derived from the 6th arch?
|
all intrinsic muscles of larynx except for cricothyroid
|
|
|
What nerve is derived from the 4th arch?
|
superior laryngeal
|
|
|
What nerve is derived from the 6th arch?
|
recurrent laryngeal
|
|
|
What arches make up the posterior third of the tongue?
|
3 and 4
|
|
|
The thyroid cartilage, and epiglottic cartilage are both from what arch?
|
4th
|
|
|
The cricoid cartilage, arytenoid cartilages, and corniculate cartilage are all from what arch?
|
6th
|
|
|
What is unique about the nerves derived from brachial arches (V2,V3,VII,IX,X)?
|
These are the only cranial nerves with both sensory and motor components
|
|
|
Clefts 2-4 form what structures and what later obliterates this structure?
|
temporary cervical sinuses which are obliterated by 2nd arch mesenchyme
|
|
|
What forms the external auditory meatus?
|
1st cleft
|
|
|
Aberrent development of the third and fourth pouches leads to what syndrome?
|
DiGeorge's syndrome
|
|
|
What pouch forms the superior parathroids?
|
dorsal 4th
|
|
|
What pouch forms the inferior parathyroids?
|
dorsal 3rd
|
|
|
What does the 2nd pouch form?
|
epithelial lining of palatine tonsil
|
|
|
What does the ventral wings of the third pouch form?
|
thymus
|
|
|
What forms the tympanic membrane?
|
1st branchial membrane
|
|
|
What are the muscles of the tongue derived from?
|
occipital myotomes
|
|
|
A cyst in the lateral neck points to what condition of development?
Medial neck? |
persistent cerival sinus (clefts 2-4)
persistent thyroglossal duct (may also form pyramidal lobe of thyroid) |
|
|
The uvula deviates to what side regarding the lesion?
|
away from the Xth nerve lesion
|
|
|
What 4 components make up the diaphramn?
|
Several Parts Build Diaphragmn: septum transversum, pleuroperitoneal folds, body wall, dorsal mesentary of esophagus
|
|
|
What does the ventral pancreatic bud form?
|
pancreatic head, uncinate and main duct
|
|
|
The spleen arises from __ mesentary but is supplied by an artery of the __?
|
dorsal, foregut
|
|
|
What is the derivation of the pancreas?
|
endodermal foregut
|
|
|
Gastroschisis is due to what condition?
|
failure of fusion of lateral body folds
|
|
|
What does the fetal urogenital sinus develop into?
|
bladder, urethra, alantois
|
|
|
What are the derivatives of the mesonephric wolfian ducts?
|
SEED: Seminal vesicles, Epididymis, Ejaculatory duct, Ductus Deferens
|
|
|
What are the derivatives of the paramesonephric (Mullerian ducts)?
|
fallopian tube, uterus, part of vagina
|
|
|
What is the function of the SRY gene on Y chromosome?
|
testes determining factor causes secretion of Mullerian inh. hormone secreted by testes supresses paramesonephric ducts, androgens are increased leading to mesonephric duct development
|
|
|
When does the pronephros degenerate?
|
wk 4
|
|
|
During what phase does the mesonephros function as a kidney?
|
first trimester
|
|
|
What stimulates the formatino of male genitalia over female genitalia?
|
DHT vs estrogen
|
|
|
What does the genital tubercle become in males and females?
|
M: glans penis
F: glans clitoris |
|
|
What does the urogenital sinus become in males.
|
bulbourethral glands, prostate, corpus spongiosum
|
|
|
What is the female equivalent of the prostate gland?
|
urethral and paraurethral glands of Skene
|
|
|
What is the female equivalent of the bulbourethral glands?
|
greater vestibular glands of bartholin
|
|
|
What are the female derivatives of the urogenital sinus?
|
vestibular bulbs, greater vestibular glands, urethral and paraurethral glands of skene
|
|
|
What are the male and femal derivatives of the urogenital fold?
|
ventral shaft of penis and penile urethra; labia minora
|
|
|
What is the embryonic tissue that forms the labia majora in females and the scrotum in males?
|
labioscrotal swelling
|
|
|
Cardiac rhabdomyomas are most often seen in what condition?
|
tuberous sclerosis
|
|
|
Children with retinoblastoma are at increased risk for what other tumor?
|
osteosarcoma
|
|
|
What HPV types are most associated with cervical carcinoma?
|
16 and 18
|
|
|
Amyloid deposits in the joints of patients on dialysis contain what type of amyloid?
|
beta2-microglobulin
|
|
|
Ribosomal detachment and chromatin clumping are examples of __ change?
|
reversible
|
|
|
Ca influx into the cell and lysosomal rupture would be associated with what mitochondrial change?
|
irreversible change causing increased mitochondrial permeability
|
|
|
Aside from TB and sarcoid, what 5 other conditions may cause granulomas?
|
syphillis, leprosy, bartonella, fungal pneumonias, Chron's disease
|
|
|
Aside from inflammation, what other condition may cause protein rich fluid to exude?
|
lymphatic blockage (specific gravity of exudate >1.020)
|
|
|
What mediates neutrophil rolling along the endothelium?
|
E-selectin and P-selectin on endothelium binding sialyl Lewis X on neutrophil
|
|
|
What mediates tight binding of neutrophil to endothemium?
|
ICAM-1 on vasc endothelium binds to LFA-1 (integrin) on leukocyte
|
|
|
What phase of drug metabolism may generate free radicals?
|
phase 1
|
|
|
What type of amyloid is formed from multiple myeloma?
|
Ig 'L'ight chains forming AL
|
|
|
Chronic inflamatory diseases for what type of amyloid?
|
SAA formin AA amyloid--'A'cute phase reactant
|
|
|
What type of amyloid is deposited in DM type 2?
|
amylin from AE--think E=Endocrine
|
|
|
What type of amyloid is deposited in the heart with aging?
|
transthyretin from AF--think AF=old Fogies
|
|
|
A patient has A-CAL amyloid deposits, what disease does this point to and what is it derived from?
|
medulary carcinoma of the thyroid, A-CAL from CALcitonin
|
|
|
A patient has beta-amyloid deposits, what does this point to and what does the beta amyloid come from?
|
Alzheimers, from APP
|
|
|
What is the dialysis associated beta2 microglobulin derived from?
|
MHC class I protein
|
|
|
What enzymes are required for a tumor to invade the basement membrane?
|
hydrolases and collagenases
|
|
|
Abnormal cells lacking differentiation, e.g. primitive cells of same tissue is what process?
|
anaplasia
|
|
|
What has more prognostic value, stage or grade?
|
stage
|
|
|
What neoplasms are associated with XP?
|
squamous cell>basal cell, melanoma
|
|
|
Chronic atrophic gastritis, pernicious anemia, postsurgical gastric remnants are associated with what neoplasms?
|
gastric adenocarcinoma
|
|
|
What 3 neoplasms are associated with tuberous sclerosis?
|
astrocytoma, angiomyolipoma, cardiac rhabdomyoma
|
|
|
What neoplasms are associated with Plummer-Vinson syndrome?
|
squamous cell carcinoma of esophagus
|
|
|
A patient has esophageal webs, atrophic glossitis, and anemia. What is the name of this condition and what is the underlying cause?
|
Plummer-Vinson is due to Fe deficiency
|
|
|
What 2 neoplasms are associated with Paget's disease?
|
secondary osteosarcoma, fibrosarcoma
|
|
|
What neoplasms are associated with autoimmune diseases?
|
lymphomas
|
|
|
What neoplasms are associated with radiation exposure?
|
sarcoma
|
|
|
NAME THAT CANCER FROM ITS ONCOGENE: abl
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CML
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NAME THAT CANCER FROM ITS ONCOGENE: c-myc
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Burkitt's lymphoma
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NAME THAT CANCER FROM ITS ONCOGENE: bcl-2
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Follicular and undifferentiated lymphomas (inhibits apoptosis)
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NAME THAT CANCER FROM ITS ONCOGENE: erb-B2
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breast, ovarian, gastric
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NAME THAT CANCER FROM ITS ONCOGENE: Ras
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Colon carcinoma
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NAME THAT CANCER FROM ITS ONCOGENE: L-myc
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lung tumor
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NAME THAT CANCER FROM ITS ONCOGENE: N-myc
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neuroblastoma
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NAME THAT CANCER FROM ITS ONCOGENE: ret
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MEN types II and III
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NAME THAT CANCER FROM ITS ONCOGENE: c-kit
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gastrointestinal stromal tumor
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NAME THAT CANCER and CHROMOSOME FROM ITS TUMOR SUPRESSOR MUTATION: Rb
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13q; retinoblastoma, osteosarcoma
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NAME THAT CANCER and CHROMOSOME FROM ITS TUMOR SUPRESSOR MUTATION: BRCA1
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17q; breast and ovarian
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NAME THAT CANCER and CHROMOSOME FROM ITS TUMOR SUPRESSOR MUTATION: BRCA2
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13q: breast
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NAME THAT 'syndrome' and CHROMOSOME FROM ITS TUMOR SUPRESSOR MUTATION: p53
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17p; Li-fraumeni
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Persons with __ are at risk for a wide range of malignancies, with particularly high occurrences of breast cancer, brain tumors, acute leukemia, soft tissue sarcomas, bone sarcomas, and adrenal cortical carcinoma.
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Li-fraumeni syndrome
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NAME THAT CANCER and CHROMOSOME FROM ITS TUMOR SUPRESSOR GENE: p16
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9p; melanoma
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NAME THAT CANCER and CHROMOSOME FROM ITS TUMOR SUPRESSOR GENE: APC
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5q; colorectal cancer
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NAME THAT CANCER and CHROMOSOME FROM ITS TUMOR SUPRESSOR GENE: WT1
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11p; Wilms tumor
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NAME THAT CANCER and CHROMOSOME FROM ITS TUMOR SUPRESSOR GENE: NF1
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17q; NF type 1
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NAME THAT CANCER and CHROMOSOME FROM ITS TUMOR SUPRESSOR GENE: NF2
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22q, NF type 2
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NAME THAT CANCER and CHROMOSOME FROM ITS TUMOR SUPRESSOR GENE: DPC
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18q, pancreatic cancer (Deleted in Pancreatic Cancer)
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NAME THAT CANCER and CHROMOSOME FROM ITS TUMOR SUPRESSOR GENE: DCC
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18q; colon cancer (Deleted in Colon cancer)
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A patient has elevated prostatic acid phosphatase, what does this point to?
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prostatic carcinoma
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Colorectal, pancreatic, breast and gastric carcinomas all secrete this tumor marker?
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CEA
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What two tumors give off alpha-fetoprotein?
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yolk sac tumor and hepatocellular carcinoma
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Hydratidiform moles, choriocarcinomas and gestational trophoblastic tumors all give off what?
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beta-hCG (they spell HCG)
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CA-125 is given off by what two tumor types?
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ovarian and malignant epithelial tumors
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S-100 is a tumor marker for what three cancers?
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melanoma, neural tumors, astrocytomas
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Aside from bone mets and obstructive biliary disease, what other condition may cause elevated alk phos?
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Paget's disease of bone
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Neuroblastoma's, lung and gastric cancers all have this tumor marker?
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bombesin
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Hairy cell leukemia has this tumor marker?
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TRAP
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CA-19-9 in the blood points to what condition?
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pancreatic adenocarcinoma
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Burkitt's lymphoma and nasopharyngeal carcinoma are both caused by this virus?
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EBV
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Body cavity fluid B-cell lymphoma is associated with what virus?
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HHV-8
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Angiosarcomas of the liver may be caused by what carcinogen?
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vinyl chloride
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CCL4 has been known to cause?
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centrilobar necrosis, fatty change
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Aflatoxins may cause?
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Hepatocellular carcinoma
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Aside from mesothelioma, asbestos may cause what other cancer?
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bronchogenic carcinoma
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Renal cell carcinoma and transitional cell carcinoma is associated with what carcinogen?
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cigarette smoke
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Esophageal and stomach cancers are most often associated with what carcinogen?
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nitrosamines
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Arsenic may cause what cancer type?
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squamous cell carcinoma
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Napthelene/aniline dyes may cause?
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transitional cell carcinoma
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Alkylating agents may cause what type of cancer?
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leukemia
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ACTH or ACTH-like peptide is a paraneoplastic syndrome from what cancer type?
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small cell carcinoma
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ADH may be elevated in what two cancer types?
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small cell carcinoma and intracranial neoplasms
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Squamous cell lung carcinoma, renal cell carcinoma and breast carcinoma may cause what paraneoplastic hormones to be secreted?
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PTH-related peptide, TGF-beta, TNF, IL-1
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Erythropoietin may be seen with what two cancers?
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renal cell and hemangioblastoma
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Lambert-Eaton syndrome is caused by what specifically and may be due to what two cancers?
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antibodies against Ca channels at NM junction due to thymoma or small cell lung carcinoma
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What four conditions may cause psammomas?
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PSaMMoma: papillary (thyroid), Serous (ovary), Meningioma, Mesothelioma
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What tumors most often metastasize to the brain?
|
Lots of Bad Stuff Kills Glia: lung, breast, skin (melanoma), Kidney (renal cell), GI
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What tumors most often metastasize to the liver?
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colon>stomach>pancreas>breast>lung
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What tumors may metastasize to bone?
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PTT Barnum Loves Kids: Prostate, Thyroid, Testes, Breast, Lung, Kidney
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What tumors are lytic to bone, blastic to bone, or both to bone?
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lung=lytic, prostate=blastic, breast=both
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What are the three most common cancers in men?
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prostate, lung, colorectal
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What are the three most common cancers in females?
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breast, lung, colorectal
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What cancers have the highest mortality in men and women?
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lung highest in both, then prostate or breast
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