Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
195 Cards in this Set
- Front
- Back
|
Opportunistic infections in AIDS
|
Pneumocystis, CMV, Cryptococcus, MAI, TB, Herpes (esophagitis), Candida (thrus, esophagitis), Cryptosporidium
|
|
|
Most Common vitamin deficiency in alcoholics
|
Folate
|
|
|
MC mental deficiency in alcoholics
|
Magnesium
|
|
|
Football injury caused by clipping from lateral side (of knee) damages what structures?
|
MCL, medial meniscus, and ACL
|
|
|
Lumbar puncture is performed at what landmark?
|
Iliac crest
|
|
|
Abnormal passive abduction of the knee indicates damage to what structure?
|
MCL
|
|
|
Anterior in ACL refers to what attachment?
|
Tibial
|
|
|
At what level is a lumbar puncture performed?
|
L3/4 or L4/5
|
|
|
Do the coronary arteries fill during systole or diastole?
|
Diastole
|
|
|
Femoral nerve damage manifests what deficit?
|
Loss of knee jerk
|
|
|
How does the course of the left recurrent laryngeal nerve differ from that of the right?
|
The left wraps around the arch of the aorta and the ligamentum arteriosum while the right wraps around the subclavian artery.
|
|
|
Where is the appendix located (surface landmarks)?
|
2/3 of the way from the umbilicus to the ASIS
|
|
|
How many lobes are in the right and left lungs and what are their names?
|
Right has 3 (superior, middle, inferior); Left has 2 (superior and inferior) and the lingula
|
|
|
Name 5 portal-systemic anastomoses
|
1.Left gastric-azygous vv.
2.Superior-Middle/Inferior rectal vv. 3.Paraumbilical-inferior epigastric 4.Retroperitoneal-renal vv. 5.Retroperitoneal-paravertebral vv. |
|
|
Name the hypothenar muscles
|
Opponens digiti minimi, abductor digiti minimi, flexor digiti minimi
|
|
|
Name the 9 retroperitoneal structures
|
1.Duodenum(2nd-4th parts)
2.Descending colon 3.Ascending colon 4.Kidney & ureters 5.Pancreas 6.Aorta 7.Inferior vena cava 8.Adrenal glands 9.Rectum |
|
|
Name the rotator cuff muscles
|
Supraspinatus, Infraspinatus, Teres minor, Subscapularis
|
|
|
Name the thenar muscles
|
Opponens pollicis, abductor pollicis brevis, flexor pollicis brevis
|
|
|
Obturator nerve damage manifests what deficit?
|
Loss of hip adduction
|
|
|
Pain from the diaphragm is usually referred where?
|
Shoulder
|
|
|
Subarachnoid space extends to what spinal level?
|
S2
|
|
|
The area of the body that contains the appendix is known as what (what point)?
|
McBurney's point
|
|
|
The femoral triangle contains what structures from lateral to medial?
|
Femoral nerve, Femoral artery, Femoral vein, Femoral canal (lymphatics)
*NAVaL* |
|
|
What dermatome is found around the inguinal ligament?
|
L1
|
|
|
The kneecaps exist in what dermatome?
|
L4
|
|
|
The nipples exist in what dermatome?
|
T4
|
|
|
The recurrent laryngeal nerve arises from what cranial nerve and supplies what muscles?
|
CN X; supplies all intrinsic muscles of the larynx except the cricothyroid muscle.
|
|
|
The SA and AV nodes are usually supplied by what artery?
|
Right Coronary Artery (RCA)
|
|
|
The spinal cord ends at what level in adults?
|
L1-L2
|
|
|
The umbilicus exists in what dermatome?
|
T10
|
|
|
The xiphoid process exists in what dermatome?
|
T7
|
|
|
Tibial nerve damage manifests what deficit?
|
Loss of plantar flexion
|
|
|
What are hernias?
|
Protrusions of peritoneum through an opening, usually sites of weakness
|
|
|
What are the boundaries of the inguinal (Hesselbach) triangle?
|
--Inferior epigastric artery
--Lateral border of the rectus abdominus --Inguinal ligament |
|
|
What are the manifestations of portal hypertension?
|
Esophageal varices; hemorrhoids; Caput medusae
|
|
|
What condition is usually associated with portal hypertension?
|
Alcoholic cirrhosis
|
|
|
What gut regions and structures does the celiac artery supply?
|
Foregut: stomach to duodenum; liver; gallbladder; pancreas
|
|
|
What gut regions and structures does the Inferior Mesenteric Artery supply?
|
Hindgut: distal 1/3 of transverse colon to upper portion of rectum
|
|
|
What gut regions and structures does the Superior Mesenteric Artery supply?
|
Midgut: Duodenum to proximal 2/3 of transverse colon
|
|
|
What is a hiatal hernia?
|
Stomach contents herniate upward thru the esophageal hiatus of the diaphragm
|
|
|
What is the arterial blood supply difference above and below the pectinate line?
|
Superior rectal a. (above) and inferior rectal a. (below)
|
|
|
What is the course of a direct inguinal hernia?
|
Thru weak abdominal wall, into the inguinal triangle, medial to the inferior epigastric artery, thru the external inguinal ring only
|
|
|
What is the course of an indirect inguinal hernia?
|
Through the internal (deep) inguinal ring and the external (superficial) inguinal ring lateral to the inferior epigastric artery and into the scrotum
|
|
|
What is the course of the ureters?
|
Pass under the uterine artery or ductus deferens
|
|
|
What is the function of Myenteric plexus? Submucosal plexus?
|
Myenteric: Coordinates motility along entire gut wall
Submucosal: Regulates local secretions, blood flow, and absorption |
|
|
What is the function of the JG cells?
|
Secrete renin and erythropoietin
|
|
|
What is the innervation difference above and below the pectinate line?
|
Above: visceral innervation; below: somatic innervation
|
|
|
What is the innervation of the diaphragm?
|
Phrenic nerve (C3,4,5)
|
|
|
What is the macula densa?
|
Sodium sensor in part of the distal convoluted distal tubule in the juxtaglomerular apparatus of the kidney
|
|
|
What is the Myenteric plexus also known as? Submucosal plexus?
|
Myenteric: Auerbach's; Submucosal: Meissner's
|
|
|
What is the relationship of the two pulmonary arteries in the lung hilum?
|
Right: anterior; Left: superior
|
|
|
What is the usual pathology above the pectinate line of the rectum?
|
internal hemorrhoids (not painful) and adenocarcinoma
|
|
|
What is the usual pathology below the pectinate line of the rectum?
|
External hemorrhoids (painful) and squamous cell carcinoma
|
|
|
What part of the heart does the LAD supply?
|
anterior interventricular septum
|
|
|
At what spinal cord level is a vertebral disk herniation most likely to occur?
|
L5/S1
|
|
|
What structure is in the femoral triangle but not in the femoral sheath?
|
Femoral nerve
|
|
|
What structures do the broad ligament contain (4)?
|
-Round ligaments of the uterus
-Ovaries -Uterine tubules -Uterine vessels |
|
|
What structures perforate the diaphragm at what vertebral levels?
|
--IVC at T8
--esophagus, vagal trunks at T10 --aorta, thoracic duct, axygous vein at T12 |
|
|
What usually provides the blood supply for the inferior left ventricle?
|
Posterior descending artery of the RCA
|
|
|
When do the JG cells secrete renin?
|
in response to decreased renal BP, decreased sodium delivery to distal tubule, and increased sympathetic tone
|
|
|
Which ligament contains the ovarian vessels?
|
Suspensory ligament of the ovary
|
|
|
Which lung is the usual site of an inhaled foreign body?
|
Right lung
|
|
|
From which cells do plasma cells differentiate?
|
B cells
|
|
|
Into what cell type does a monocyte differentiate in tissues?
|
Macrophages
|
|
|
Name the three types of leukocytic granulocytes
|
basophils, eosinophils, and neutrophils
|
|
|
Name the two types of mononuclear leukocytes
|
Lymphocytes and monocytes
|
|
|
What are 3 functions of a macrophage?
|
- pagocytosis of bacteria, cell debris, and senescent red cells
- scavenges damaged cells and tissues - can function as an antigen presenting cell |
|
|
What are 4 characteristics of the plasma cell morphology?
|
- Off center nucleus
- Clock face chromatin distribution - Abundant RER - Well developed Golgi apparatus |
|
|
What are 4 morphologic characteristics of lymphocytes?
|
- Round
- Small - Densely staining nucleus - Small amount of pale cytoplasm |
|
|
What are 4 substances contained within the lysosomes of neutrophils?
|
- hydrolytic enzymes
- lysozyme - myeloperoxidase - lactoferrin |
|
|
What are 4 types of cells into which T cells differentiate?
|
- cytotoxic T cells (MHC I, CD8)
- helper T cells (MHCII, CD4) - suppressor T cells - delayed hypersensitivity T cells |
|
|
What are the components of the air-blood barrier?
|
- Type I pneumocyte
- tight junction - endothelial cell |
|
|
What are two names for an increased number of red cells?
|
Erythrocytosis and polycythemia
|
|
|
What immunoglobulin can bind to the membrane of a mast cell?
|
IgE
|
|
|
What is a reticulocyte?
|
a baby (developing) erythrocyte
|
|
|
What percentage of leukocytes in the blood exist as basophils?
|
Less than 1%
|
|
|
What is the basic morphologic structure of an erythrocyte?
|
Anucleate, biconcave
|
|
|
What is the function of Interferon gamma with relation to macrophages?
|
Macrophage activation
|
|
|
What is the function of pulmonary surfactant?
|
lowers alveolar surface tension and prevents atelectasis
|
|
|
What is the importance of the lecithin:sphingomyelin ratio?
|
> 2.0 in fetal lung is indicative of fetal lung maturity
|
|
|
Are most pericardial effusions serous or hemorrhagic?
|
Serous
|
|
|
BActerial endocarditis of which valve is associated with IV drug abuse?
|
Tricuspid
|
|
|
Characterize EKG changes in an MI
|
ST elevation (transmural ischemia) and Q waves
|
|
|
What is the most specific protein marker for an MI? Time frame?
|
Troponin - elevated between 4 hrs and 7-10 days post MI
|
|
|
Describe the onset of Staph. Aureus endocarditis
|
Rapid, acute onset
|
|
|
Describe the onset of Streptococcus viridans endocarditis
|
Insidious, subacute onset
|
|
|
How does atherosclerosis progress?
|
1. Fatty streaks in arteries
2. proliferative plaques 3. complex atheromas |
|
|
How does Prinzmental's variant angina present?
|
chest pain at rest
|
|
|
How does stable angina present?
|
Chest pain with exertion
|
|
|
How does syphilis change the aorta?
|
Causes dilation of the aorta and valve ring. Can result in aortic aneurysm or aortic valve incompetence
|
|
|
How does unstable/crescendo angina present?
|
worsening chest pain
|
|
|
To what does HTN predispose one (5)?
|
Coronary heart dz, CVA, CHF, renal dz, and aortic dissection
|
|
|
What are fat emboli associated with (2)?
|
long bone fractures and liposuction
|
|
|
What are Janeway lesions?
|
Small erythematous lesions on palms or soles
|
|
|
What are osler nodes?
|
tender raised lesions on finger or toe pads
|
|
|
What are the risk factors for HTN (6)?
|
Age, obesity, diabetes, smoking, genetics, race (black>white>asian)
|
|
|
What are Roth's spots?
|
round white spots on retina surrounded by hemorrhage
|
|
|
What are the 3 most common sites of an MI?
|
LAD > RCA > circumflex
|
|
|
What are the 3 types of angina in ischemic heart dz?
|
stable angina, prinzmetal's variant and unstable/crescendo
|
|
|
What are the 7 types of heart murmurs?
|
1. Aortic stenosis
2. Aortic regurgitation 3. Mitral stenosis 4. Mitral regurgitation 5. Mitral prolapse 6. Vent. Septal defect 7. Patent ductus arteriosus |
|
|
What are the findings in temporal arteritis?
|
1. Unilateral headache
2. Jaw claudication 3. Impaired vision 4. Systemic involvement with polymyalgia rheumatica (in 50% of patients) |
|
|
What are the findings in Buerger's dz?
|
Intermittent claudication, superficial nodular phlebitis, cold sensitivity (Raynaud's phenom.), severe pain in affected part; may lead to gangrene
|
|
|
What are the findings in pericarditis (4)?
|
1. pericardial pain
2. friction rub 3. EKG changes 4. pulsus paradoxicus |
|
|
What is Pulsus paradoxicus?
|
A drop of more than 10-12 mmHg of blood pressure during inspiration
|
|
|
What are the findings of Wegener's granulomatosis (3)?
|
1. C-ANCA positive
2. CXR reveals large nodular lesions 3. hematuria and red cell casts |
|
|
What are the risk factors of atherosclerosis (4)?
|
smoking, HTN, diabetes mellitus, and hyperlipidemia
|
|
|
What are the signs of a pulmonary embolus (3)?
|
chest pain, tachypnea, and dyspnea
|
|
|
What are the symptoms of an MI (5)?
|
severe retrosternal pain, pain in left arm or jaw, shortness of breath, fatigue and adrenergic symptoms
|
|
|
What are the symptoms of polyarteritis nodosa (6)?
|
fever, weight loss, malaise, abdominal pain, myalgia, and HTN
|
|
|
What are the types of emboli (6)?
|
Fat, Air, Thrombus, Bacteria, Amniotic fluid, Tumor
|
|
|
All viruses are haploid except ____?
|
Retroviruses, which have 2 identical ssRNA molecules (diploid)
|
|
|
Bites from what 3 animals are more prone to rabies infection than a bite from a dog?
|
Bat, raccoon, and skunk
|
|
|
Define genetic drift
|
Minor changes based on random mutations
|
|
|
Define genetic shift
|
reassortment of viral genome (2+ viruses sharing genomes)
|
|
|
How do the S. Schenckii yeast appear in the pus?
|
Cigar-shaped budding yeast
|
|
|
How do you diagnose cryptosporidium?
|
Cysts on acid fast stain
|
|
|
How do you diagnose giardiasis?
|
Trophozoites or cysts in stool
|
|
|
How does Aspergillus appear microscopically?
|
Mold with septate hyphae that branch at a V-shaped (45 degree angle) - they are NOT dimorphic
|
|
|
How is Schistosoma transmitted and what disease results?
|
snails are host; cercariae penetrate skin of humans; causes granulomas, fibrosis, and inflammation of the spleen and liver
|
|
|
What are the 3 main roles of Ig binding to bacteria?
|
Opsonization; neutralization; complement activation
|
|
|
After exposure to what 4 things are performed (passive) antibodies given?
|
Tetanus toxin, Botulinum toxin, HBV, or Rabies
|
|
|
All nucleated cells have what class of MHC proteins?
|
Class I MHC protiens
|
|
|
Anaphylaxis, asthma, or local wheal and flare are possible manifestations of which type of hypersensitivity?
|
Type I
|
|
|
Anti-gliadin autoantibodies are associated with what disease?
|
Celiac disease
|
|
|
Anti-Scl-70 autoantibodies are associated with what disease?
|
diffuse Scleroderma
|
|
|
Autoimmune hemolytic anemia, Rh disease (erythroblastosis fetalis), and Goodpasture's syndrome are examples of what kind of hypersensitivity reaction?
|
type II hypersensitivity
|
|
|
Class I major histocompatibility complex consists of...
|
1 polypeptide, with B2-microglobulin
|
|
|
Class II MHC consists of...
|
2 polypeptides, an alpha and a beta chain
|
|
|
Cytotoxic T cells have CD(?), which binds to class (?) MHC on virus-infected cells
|
CD8 binds to class I MHC
|
|
|
Define acute transplant rejection.
|
Cell-mediated due to cytotoxic T lymphocytes reacting against foreign MHCs. Occurs weeks after transplantation.
|
|
|
Define adjuvant
|
Adjuvants are nonspecific stimulators of the immune response but are not immunogenic by themselves
|
|
|
Define chronic transplant rejection
|
Antibody-mediated vascular damage (fibrinoid necrosis)--irreversible. Occurs months to years after transplantation
|
|
|
Define hyperacute transplant rejection
|
Antibody-mediated due to the presence of pre-armed anti-donor antibodies in the transplant recipient. Occurs within minutes after transplantation
|
|
|
Goodpasture's syndrome is associated with what kind of autoantibodies?
|
anti-basement membrane antibodies
|
|
|
Helper T cells have CD(?) which binds to class (?) MHC on antigen-presenting cells
|
CD4 binds to class II MHC
|
|
|
IL-4 promotes the growth of B cells and the synthesis of what 2 immunoglobulins?
|
IgE and IgG
|
|
|
In what immune deficiency do neutrophils fail to respond to chemotactic stimuli?
|
Job's syndrome
|
|
|
MHC I Ag loading occurs in __(1?)__ while MHC II Ag loading occurs in __(2?)__?
|
(1) in rER (viral antigens)
(2) in acidified endosomes |
|
|
Role of TH1 cells?
|
produce IL-2 (activate Tc cells and further stimulate TH1 cell) and gamma-interferon (activate macrophages)
|
|
|
Role of TH2 cells?
|
produce IL-4 and IL-5 (help B cells make Ab)
|
|
|
: TB skin test, transplant rejection, and contact dermatitis are examples of what type of hypersensitivity reaction?
|
Type IV
|
|
|
The 3 kinds of MHC class I genes are...
|
A, B, and C
|
|
|
The 3 kinds of MHC class II genes are...
|
DP, DQ, DR
|
|
|
What 2 cytokines are secreted by macrophages?
|
IL-1 and TNF-alpha
|
|
|
What 2 kinds of autoantibodies are specific for systemic lupus?
|
Anti-dsDNA and anti-Smith
|
|
|
What 3 cytokines are classified as 'acute phase cytokines'?
|
IL-1, IL-6, and TNF-alpha
|
|
|
What antibody isotype can cross the placenta?
|
IgG
|
|
|
What are the 3 types of APCs?
|
Macrophages, B cells and dendritic cells
|
|
|
What complement components can cause anaphylaxis?
|
C3a and C5a
|
|
|
What elements of the complement cascade made the Membrane Attack Complex (MAC)?
|
C5b, C6, C7, C8, and C9
|
|
|
What Ig is found in secretions as a monomer or a dimer?
|
IgA
|
|
|
What Ig is found in secretions as a monomer or a pentamer?
|
IgM
|
|
|
What immunoglobulin isotype has the lowest concentration in serum?
|
IgE
|
|
|
What immunoglobulin isotype is involved in type-I hypersensitivity reactions?
|
IgE
|
|
|
What immunoglobulin isotype is produced in the primary response to an antigen and is on the surface of B cells?
|
IgM
|
|
|
What interleukin induces naive helper T-cells to become TH2 cells?
|
IL-4
|
|
|
What interleukin stimulates the growth of both helper and cytotoxic T-cells?
|
IL-2
|
|
|
What kind of autoantibodies are associated with CREST/Scleroderma?
|
Anti-centromere antibodies
|
|
|
What kind of autoantibodies are known as rheumatoid factor?
|
anti-IgG antibodies
|
|
|
Which interleukin stimulates the production and activation of eosinophils?
|
IL-5
|
|
|
After the first breath at birth, what causes closure of the ductus arteriosus?
|
An increase in oxygen
|
|
|
After the first breath at birth, what causes the closure of the foramen ovale?
|
A decrease resistance in pulmonary vasculature causes increased left atrial pressure vs. right atrial pressure
|
|
|
At what time in the course of development is the fetus most susceptible to teratogens?
|
Weeks 3-8
|
|
|
Deoxygenated blood from the SVC is expelled into the pulmonary artery and ____ ____ to the lower body of the fetus.
|
ductus arteriosus
|
|
|
Do the cardiovascular structures arise from neural crest (ectoderm), mesoderm, or endoderm?
|
Mesoderm
|
|
|
Do the lungs arise from neural crest (ectoderm), mesoderm, or endoderm?
|
Endoderm
|
|
|
Do the lymphatics arise from neural crest (ectoderm), mesoderm, or endoderm?
|
Mesoderm
|
|
|
Do the neural crest cells arise from mesoderm, ectoderm, or endoderm?
|
Ectoderm
|
|
|
Do the urogenital structures arise from neural crest (ectoderm), mesoderm, or endoderm?
|
Mesoderm
|
|
|
Does bone arise from neural crest (ectoderm), mesoderm, or endoderm?
|
Mesoderm
|
|
|
Does muscle arise from neural crest (ectoderm), mesoderm, or endoderm?
|
Mesoderm
|
|
|
Does the adrenal cortex arise from neural crest (ectoderm), mesoderm, or endoderm?
|
Mesoderm
|
|
|
From what does the ligamentum teres hepatis arise?
|
umbilical vein
|
|
|
How does a bicornate uterus form?
|
Results from incomplete fusion of the paramesonephric ducts
|
|
|
How does a horseshoe kidney form?
|
Inferior poles of both kidneys fuse, as they ascend from the pelvis during development they get trapped under the inferior mesenteric artery, and remain low in the abdomen
|
|
|
How many arteries and veins does the umbilical cord contain?
|
- 2 umbilical arteries (carries deoxygenated blood away from fetus)
- 1 umbilical vein (oxygenated blood to fetus) |
|
|
Meiosis I is arrested in which phase until ovulation?
|
Prophase
|
|
|
Most oxygenated blood reaching the heart via IVC is diverted through the ____ ____ and pumped out the aorta to the head.
|
Foramen ovale
|
|
|
What are the five 2's associated with meckel's diverticulum?
|
- 2 inches long
- 2 feet from the ileocecal valve - 2% of the population - Commonly presents in the first 2 years of life - May have 2 types of epithelia (gastric and pancreatic) |
|
|
What does the ductus arteriosus give rise to?
|
ligamentum arteriosum
|
|
|
What does catalase do? What bacteria have this?
|
Destroys hydrogen peroxide (major problem for CGD pts);
Staphylococcus, Pseudomonas, Aspergillus, Candida, Enterobacteriaceae |
|
|
What does IgA protease do? What bacteria have this?
|
Destroys IgA, promotes colonization of mucosal surfaces; Neisseria, Haemophilus, Streptococcus pneumoniae
|
|
|
What does oxidase do? What bacteria have this?
|
possession of cytochrome c oxidase; Neisseria and most gram-negatives, except the enterobacteriaceae
|
|
|
What does coagulase do? What bacteria have this?
|
produces fibrin clot; Staphylococcus aureus and Yersinia pestis
|
|
|
What must be added to the media in order to grow Haemophilus?
|
Factors X and V
|
|
|
What must be added to the media in order to grow Mycoplasma?
|
Cholesterol
|
|
|
What must be added to the media in order to grow Staphylococcus aureus, group D enterococci and vibrio?
|
High salt
|
|
|
What must be added to the media in order to grow Francisella, Legionella, Brucella, and Pasteurella?
|
Cysteine
|
|
|
What antimicrobial agents inhibit bacterial cell-wall synthesis?
|
penicillins, cephalosporins, imipenem/meropenem, aztreonam, vancomycin
|
|
|
What antimicrobial agents inhibit bacterial protein synthesis?
|
Aminoglycosides, chloramphenicol, macrolides, tetracyclines, streptogramins, linezolid
|
|
|
What antimicrobial agents inhibit DNA replication or transcription?
|
Fluoroquinolones, rifampin
|
|
|
What antimicrobial agents inhibit nucleic acid synthesis?
|
Trimethoprim, flucytosine
|
|
|
What antimicrobial agents inhibit folic acid synthesis?
|
Sulfonamides, trimethoprim, pyrimethamine
|
|
|
What antimicrobial agents disrupt the cell membrane function?
|
Azole, polyene antifungal agents
|
|
|
What are the 1st generation penicillins? 2nd? 3rd? 4th?
|
1st: penicillin G, penicillin V
2nd: methicillin, nafcillin 3rd: ampicillin, amoxicillin 4th: mezlocillin, piperacillin, carbenicillin, ticarcillin |
