First Aid 2010 Mnemonics-01

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Negative-stranded Viruses

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Always Bring Polymerase Or Fail Replication Horribly. (Arenaviruses, Bunyaviruses, Paramyxoviruses, Orthomyxoviruses, Filoviruses, Rhabdoviruses, and Hepatitis delta virus.)

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Segmented viruses

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BOAR. (Bunyaviruses, Orthomyxoviruses (influenza viruses),Arenaviruses, and Reoviruses.)

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Picoruavirus

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PERCH (Poliovirus. Echovirus. Rhinovirus, Coxsackievirus, HAV)

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TORCH infection

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a set of perinatal infections: Toxoplasmosis; Other infections; Rubella; CMV; HSV

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3 C’s of measles

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Cough; Coryza; Conjunctivitis

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Negri body

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cytoplasmic inclusions in neurons infected by rabies virus.

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Arboviruses

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Fever Transmitted by Bites (Flavivirus, Togavirus, and Bunyavirus )

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Block protein synthesis at 50S ribosomal subunit

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Chloramphenicol, macrolides, clindamycin, streptogramins (quinupristin, dalfopristin), linezolid

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Block protein synthesis at 30S ribosomal subunit

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Aminoglycosides, tetracylines

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Bacteriostatic

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Erythromycin. Clindamycin, Sulfamethoxazole, Trimethoprim, Tetracyclines, Chloramphenicol

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Bactericidal

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Vancomycin, FluoroquinoIones, Penicillin,Aminoglycosides, Cephalosporins, Metronidazole.

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ampicillin/amoxcillin coverage

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HELPS kill enterococci (Haemophilus influenzae, E. coli. Listeria monocytogenes, Proteus mirabilis. Salmonella, enterococci)

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Ticarcillin, carbenicillin, piperacillin

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TCP: Takes Care of Pseudomonas.

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Cephalosporins 1st generation

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PEcK: Proteus mirabilis, E. eoli. Klebsiella pneumoniae

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Cephalosporins 2st generation

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HEN PEcKS: Haemophilus influenzae. Enterobacter aerogenes. Neisseria spp., Proteus mirabilis, E. coli, Klebsiella pneumoniae, Serratia marcescens

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Tetracyclines clinical use

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VACUUM THe Bed Room. Vibrio cholerae, Acne, Chlamydia, Ureaplasma, Urealyticum, Mycoplasma pneumoniae, Tularemia, H. pylori, Borrelia burgdorferi (Lyme disease), Rickettsia.

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Sulfa drug allergies

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sulfonamides, sulfasalazine, sulfonylureas, thiazide diuretics, acetazolamide, or furosemide.

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Anaerobic infection above the diaphragm

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Clindamycin

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Anaerobic infection below the diaphragm

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Metronidazole

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Metronidazole clinical use

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GET GAP on the Metro! Antiprotozoal. Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (Bacteroides, Clostridium). H. Pylori

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side effect of ethambutol

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optic neuropathy (red-green color blindness)

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Rifampin’s 4 R’s

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RNA polymerase inhibitor; Revs up microsomal P-450; Red/orange body fluids; Rapid resistance if used alone

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Antibiotics to avoid in pregnancy

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SAFE Moms Take Really Good Care. Sulfonamides––kernicterus. Aminoglycosides––ototoxicity. Fluoroquinolones––cartilage damage. Erythromycin––acute cholestatic hepatitis in mom (and clarithromycin––embryotoxic). Metronidazole––mutagenesis. Tetracyclines––discolored teeth, inhibition of bone growth. Ribavirin (antiviral)––teratogenic. Griseofulvin (antifungal)––teratogenic. Chloramphenicol––“gray baby.”

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VACTERL

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Mesodermal defects: Vertebral defects, Anal atresia, Cardiac defects, Tracheo-Esophagcal fistula, Renal defects. Limb detects (bone and muscle).

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Fetal erythropoiesis

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Young Liver Synthesizes Blood. 1. Yolk sac (3-8 wk) 2. Liver (6-30 wk) 3. Spleen (9-28 wk) 4. Bone marrow (28 wk onward)

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Branchial apparatus

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CAP: Clefls = ectoderm, Arches = mesoderm, Pouches = endoderm

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HLA-DR2

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Multiple sclerosis, hay fever, SLE, Goodpasture's

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HLA-DR3

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Diabetes mellitus type 1

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HLA-DR4

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Rheumatoid arthritis, diabetes mellilus type l

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HLA-DR5

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Pernicious anemia→B12 deficiency, Hshimoto's thyroiditis.

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HLA-DR7

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Steroid-responsive nephrotic syndrome

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HLA-B8

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Craves' disease.

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HLA-A3

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Hemochromatosis

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cytokines function

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Hot T-Bone stEAk: IL-1: fever (Hot); IL-2: stimulate T cells; IL-3: stimulates Bone marrow. IL-4: stimulates IgE production. IL-5: stimulate IgA production. IL-8 major chemotactic factor for neutrophils. IL-10 inhibits Th1 activates Th2. IL-12 activates NK and Th1. γ-interferon stimulates macrophages, activates Th1, inhibits Th2. TNF keukocyte recruitment, vscular leak, septic shock.

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Cell surface proteins, Helper T cells

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CD4, TCR, CD3, CD28, CD40L

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Cell surface proteins, Cytotoxic T cells

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CD8, TCR, CD3

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Cell surface proteins, B cells

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IgM, CD19, CD20, CD21 (receptor for EBV), CD40, MHC II, B7

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Cell surface proteins, Macrophages

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MHC II, B7, CD40, CD14. Receptors for Fc and C3b.

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Cell surface proteins, NK cells

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Receptors for MHC I, CD16 (binds Fc of IgG), CD56.

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Cell surface proteins,All cells except mature red cells

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MHC I.

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Antinuclear antibodies (ANA)

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SLE

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Anti-dsDNA, anti-Smith

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Specific for SLE

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Antihistone

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Drug-induced lupus

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Anti-IgG

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Rheumatoid arthritis (rheumatoid factor)

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Anticentromere

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Scleroderma (CREST)

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Anti-Scl-70 (anti-DNA topoisomerase I)

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Scleroderma (diffuse)

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Antimitochondrial

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1° biliary cirrhosis

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Antigliadin, antiendomysial

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Celiac disease

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Anti–basement membrane

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Goodpasture’s syndrome

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Anti–desmoglein

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Pemphigus vulgaris

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Antimicrosomal, antithyroglobulin

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Hashimoto’s thyroiditis

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Anti-Jo-1

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Polymyositis, dermatomyositis

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Anti-SS-A (anti-Ro), Anti-SS-B (anti-La)

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Sjögren’s syndrome

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Anti-U1 RNP (ribonucleoprotein)

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Mixed connective tissue disease

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Anti–smooth muscle

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Autoimmune hepatitis

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Anti–glutamate decarboxylase

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Type 1 diabetes mellitus

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c-ANCA

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Wegener’s granulomatosis

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p-ANCA

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Other vasculitides

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Hypersensitivity disorders: Allergic rhinitis (hay fever)

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Type I

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Hypersensitivity disorders: eczema

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Type I

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Hypersensitivity disorders: hives

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Type I

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Hypersensitivity disorders: asthma

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Type I

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Hypersensitivity disorders: Hemolytic anemia

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Type II

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Hypersensitivity disorders: pernicious anemia

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Type II

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Hypersensitivity disorders: Idiopathic thrombocytopenic purpura

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Type II

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Hypersensitivity disorders: Erythroblastosis fetalis

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Type II

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Hypersensitivity disorders: Rheumatic fever

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Type II

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Hypersensitivity disorders: Goodpasture’s syndrome

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Type II

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Hypersensitivity disorders: Bullous pemphigoid

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Type II

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Hypersensitivity disorders: Pemphigus vulgaris

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Type II

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Hypersensitivity disorders: Graves’ disease

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Type II

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Hypersensitivity disorders: Myasthenia gravis

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Type II

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Hypersensitivity disorders: SLE

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Type III

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Hypersensitivity disorders: Rheumatoid arthritis

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Type III

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Hypersensitivity disorders: Polyarteritis nodosa

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Type III

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Hypersensitivity disorders: Poststreptococcal glomerulonephritis

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Type III

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Hypersensitivity disorders: Serum sickness

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Type III

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Hypersensitivity disorders: Arthus reaction (e.g., swelling and inflammation following tetanus vaccine)

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Type III

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Hypersensitivity disorders: Hypersensitivity pneumonitis (e.g., farmer's lung)

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Type III

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Hypersensitivity disorders: Type I DM

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Type IV

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Hypersensitivity disorders: Multiple sclerosis

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Type IV

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Hypersensitivity disorders: Guillain-Barré syndrome

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Type IV

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Hypersensitivity disorders:Hashimoto’s thyroiditis

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Type IV

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Hypersensitivity disorders: Graft-versus-host disease

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Type IV

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Hypersensitivity disorders: PPD (test for M. tuberculosis)

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Type IV

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Hypersensitivity disorders: Contact dermatitis

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Type IV

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Bruton's agammaglobulinemia

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[XR]. Defect in BTK, a tyrosine kinase gene → blocks B-cell differentiation/maturation. Recurrent bacterial infections after 6 months due to opsonization defect. Normal pro-B,↓ maturation, ↓ number of B cells, ↓ immunoglobulins of all classes.

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Hyper-IgM syndrome

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Defective CD40L on helper T cells = inability lo class switch. Severe pyogenic infections early in life. ↑ IgM; ↓↓IgG, IgA. IgE.

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Selective Ig deficiency

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Defect in isotype switching →deficiency in specific class of immunoglobulins. Sinus and lung infections, milk allergies and diarrhea. Anaphylaxis on exposure to blood products with IgA. IgA deficiency most common. Failure to mature into plasma cells, ↓secretory IgA.

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Common variable immimodeficiency (CVID)

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Defect in B-cell maturation; many causes. Can be acquired in 20s-30s; ↑ risk of autoimmune disease, lymphoma, sinopulmonary Infections. Normal number of B cells;↓ plasma cells, immunoglobulin.

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IL-12 receptor deficiency

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↓Th1 response. Disseminated mycobacterial infections. ↓ IFN-γ.

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Hyper-IgE syndrome (Job's syndrome)

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Th cells fail to produce IFN-y→ inability of neutrophils to respond to chemotactic stimuli. FATED: coarse Facies, cold (noninflamed) staphylococcal Abscesses, retained primary Teeth, ↑ IgE, Dermatologic problems (eczema).

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Severe combined immunodeficiency (SCID)

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Several types: defective IL-2 receptor (most common, X-linked), adenosine deaminase deficiency, failure to synthesize MHC II antigens. Recurrent viral, bacterial. fungal, and protozoal infections due to both B-and T-cell deficiency, Treatment: bone marrow Iransplant (no allograft rejection).

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Ataxia-telangiectasia

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Defect in DNA repair enzymes. Triad: cerebellar defects (ataxia), spider angiomas (telangiectasia}, IgA deficiency.

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Wiskott-Aldrich syndrome

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[XR]. Progressive deletion of B and T cells. TIE: Thrombocytopenic purpura, Infections, Eczema. ↑ IgE. IgA; ↓ IgM.

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Leukocyte adhesion deficiency (type 1)

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Defect in LFA-1 integrin (CD 18) protein on phagocytes. Recurrent bacterial infections, absent pus formation, delayed separation of umbilicus. Neutrophilia.

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Chédiak-Higashi syndrome

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[AR]; defect in microtubular function with ↓ phagocytosis. Recurrent pyogenic infections by staphylococci and streptococci; partial albinism, peripheral neuropathy.

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Chronic granulomatous disease (CGD)

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Lack of NADPH oxidase → reactive oxygen species (e.g., superoxide) and absent respiratory burst in neutrophils.↑susceptibity to catalase-positive organisms (e.g., S. aureus, E. coli, Aspergillus). Negative Nitroblue tetrazolium dye reduction test.

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Aldesleukin

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interleukin-2. Renal cell carcinoma, metastatic melanoma

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Filgrastim

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granulocyte colony-stimulating factor. Recovery of bone marrow

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Sargramostim

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GM-CSF, Recovery of bone marrow

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α-interferon

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Hepatitis B and C, Kaposi’s sarcoma, leukemias, malignant melanoma

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β-interferon

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Multiple sclerosis

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γ-interferon

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Chronic granulomatous disease

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Oprelvekin

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interleukin-11. Thrombocytopenia

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Neutrophils chemotaxis

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CILK: C5a, IL-8, Leukotriene B4, and Kallikrein recruit

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Granulomatous diseases

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1. TB (cascatiiig), 2. syphilis. 3. Listeria monocytogenes. 4. Wegener's granulomatosis. 5. leprosy, 6. Bartonella, 7. some fungal pneumonias. 8. sarcoidosis, 9. Crohn's disease. Granuloma formation is IL-2, interferon-y mediated.

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Oncogenes: abl

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CML

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Oncogenes: c-myc

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Burkitt’s lymphoma

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Oncogenes: bcl-2

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Follicular and undifferentiated lymphomas (inhibits apoptosis)

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Oncogenes: erb-B2

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Breast, ovarian, and gastric carcinomas

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Oncogenes: ras

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Colon carcinoma

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Oncogenes: L-myc

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Lung tumor

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Oncogenes: N-myc

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Neuroblastoma

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Oncogenes: ret

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Multiple endocrine neoplasia (MEN) types II and III

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Oncogenes: c-kit

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Gastrointestinal stromal tumor (GIST)

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Tumor suppressor gens: Rb

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13q, Retinoblastoma, osteosarcoma

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Tumor suppressor gens: BRCA1

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17q, Breast and ovarian cancer

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Tumor suppressor gens: BRCA2

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13q, Breast cancer

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Tumor suppressor gens: p53

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17p, Most human cancers, Li-Fraumeni syndrome

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Tumor suppressor gens: p16

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9p, Melanoma

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Tumor suppressor gens: APC

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5q, Colorectal cancer

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Tumor suppressor gens: WT1

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11p, Wilms’ tumor

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Tumor suppressor gens: NF1

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17q, Neurofibromatosis type 1

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Tumor suppressor gens: NF2

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22q, Neurofibromatosis type 2

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Tumor suppressor gens: DPC

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18q, Pancreatic cancer. DPC––Deleted in Pancreatic Cancer.

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Tumor suppressor gens: DCC

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18q, Colon cancer. DCC––Deleted in Colon Cancer.

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Tumor markers: Bombesin

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Neuroblastoma, lung and gastric cancer.

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Tumor markers: TRAP

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Tartrate-resistant acid phosphatase. Hairy cell leukemia––a B-cell neoplasm.

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Tumor markers: S-100

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Melanoma, neural tumors, astrocytomas.

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Chemical carcinogens: Aflatoxins

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Liver (hepatocellular carcinoma)

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Chemical carcinogens: Vinyl chloride

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Liver (angiosarcoma)

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Chemical carcinogens: CCl4

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Liver (centrilobular necrosis, fatty change)

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Chemical carcinogens: Nitrosamines

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Esophagus, stomach

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Chemical carcinogens: Cigarette smoke

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Larynx (squamous cell carcinoma), lung (squamous cell and small cell carcinoma), renal cell carcinoma, bladder (transitional cell carcinoma)

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Chemical carcinogens: Asbestos

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Lung (mesothelioma and bronchogenic carcinoma)

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Chemical carcinogens: Arsenic

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Skin (squamous cell carcinoma), Liver (angiosarcoma)

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Chemical carcinogens: Naphthalene (aniline) dyes

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Bladder (transitional cell carcinoma)

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Psammoma bodies

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PSaMMoma: Papillary adenocarcinoma of thyroid; Serous papillary cystadenocarcinoma of ovary; Meningioma; Malignant mesothelioma

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Metastasis to brain

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Lots of Bad Stuff Kills Glia. Lung, Breast, Skin (melanoma), Kidney (renal cell carcinoma), GI, Overall, approximately 50% of brain tumors are from metastases.

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Metastasis to liver

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Cancer Sometimes Penetrates Benign Liver. Colon > Stomach > Pancreas > Breast > Lung.

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Metastasis to bone

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Prostate (blastic), Breast (Both lytic and blastic), Thyroid, Testes, Lung (Lytic), Kidney.

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Selective β2-agonists

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MAST: Metaproterenol and Albuterol for acute asthma; Salmeterol for long-term treatment; Terbutaline to reduce premature uterine contractions

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β1-selective antagonists

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A BEAM: Acebutolol, Betaxolol, Esmolol, Atenolol, Metoprolol

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Specific antidotes: Acetaminophen

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N-acetylcysteine

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Specific antidotes: Salicylates

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NaHCO3 (alkalinize urine), dialysis

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Specific antidotes: Amphetamines (basic)

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NH4Cl (acidify urine)

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Specific antidotes: Anticholinesterases, organophosphates

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Atropine, pralidoxime

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Specific antidotes: Antimuscarinic, anticholinergic agents

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Physostigmine salicylate

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Specific antidotes: β-blockers

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Glucagon

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Specific antidotes: Digitalis

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Stop dig, normalize K+, lidocaine, anti-dig Fab fragments, Mg2+

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Specific antidotes: Iron

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Deferoxamine

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Specific antidotes: Lead

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CaEDTA, dimercaprol, succimer, penicillamine

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Specific antidotes: Arsenic, mercury, gold

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Dimercaprol (BAL), succimer

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Specific antidotes: Copper, arsenic, gold

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Penicillamine

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Specific antidotes: Cyanide

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Nitrite, hydroxocobalamin, thiosulfate

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Specific antidotes: Methemoglobin

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Methylene blue

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Specific antidotes: Carbon monoxide

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100% O2, hyperbaric O2

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Specific antidotes: Methanol, ethylene glycol (antifreeze)

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Ethanol, dialysis, fomepizole

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Specific antidotes: Opioids

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Naloxone/naltrexone

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Specific antidotes: Benzodiazepines

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Flumazenil

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Specific antidotes: TCAs

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NaHCO3 (serum alkalinization)

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Specific antidotes: Heparin

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Protamine

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Specific antidotes: Warfarin

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Vitamin K, fresh frozen plasma

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Specific antidotes: tPA, streptokinase

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Aminocaproic acid

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Drug reactions: Cutaneous flushing

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VANC: Vancomycin, Adenosine, Niacin. Ca+ channel blockers

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Drug reactions: Hemolysis in G6PD-decicient patients

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hemolysis IS PAIN: Isoniazid (INH), Sulfonamides, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin

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Drug reactions: Megaloblastic anemia

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PMS: Phenytoin, Methotrexate, Sulfa drugs

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Drug reactions: Pulmonary fibrosis

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Bleomycin, amiodarone, busulfan

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Drug reactions: Gynecomastia

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Spironolactone, Digitalis, Cimetidine, chronic Alcohol use, estrogens, Ketoconazole. (Some Drugs Create Awesome Knockers)

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Drug reactions: Photosensitivity

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SAT for a photo: Sulfonamides, Amiodarone, Tetracycline

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Drug reactions: SLE-like syndrome

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Hydralazine, INH, Procainamide, Phenytoin (it’s not HIPP to have lupus)

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P-450 Inducers

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Quinidine, Barbiturates, St, John's wort, Phenytoin, Rifampin, Griseofulvin, Carbamazepine, Chronic alcohol use

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P-450 Inhibitors

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Sulfonamides, Isoniazid, Cimetidine, Ketoconazole, Erythromycin, Grapefruit juice, Acute alcohol use

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Sulfa drugs

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celecoxib, furosemide, thiazides, TMP-SMX, sulfonyureas, sulfasalazine.