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340 Cards in this Set
- Front
- Back
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ERYTHEMA MARGINATUM
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Little red spots w/ bright red margins
Sandpapery RF- Jones critera |
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ERYTHEMIA CHRONICUM MIGRANS
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Lymes disease
Target lesions (bulls eye) |
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MEASLES
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Morbiliform rash
Preceded by cough conjunctiivitis |
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ROSEOLA
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Fever x 2 day
Followed by rash ONLY ONE WITH RASH FOLLOWING FEVER (HHV 6) |
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ERYTHEMA NODOSUM
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Anterior aspect of leg
Redness Tender nodules |
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Erythema multiforme
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Red macules, target lesions
Causes: allergy, viruses Mild: MCC virus, #2 drugs (sulfas) Moderate: Stevens-Johnsons Syndrome Severe: Toxic epidermal necrolysis , skin peels off |
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SEBORRHEIC DERMATITIS
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Scaly skin with oily shine on headline
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SEBORRHEIC KERATOSIS
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Stuck on warts
Due to aging |
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PSORIASIS
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HLA-B27
Extensor surfaces Silvery white plaques Scaly skin Pitted nails |
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VARICELLA ZOSTER HHV 3
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STAGES
Red macules Papules Vesicles Pustules then scabs Different stages may appear at same time |
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DERMATITIS HERPATIFORMIS
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Rash and blisters on ant. thighs
Assoc. with diarrhea Assoc. with flare up of celiac sprue |
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TYPHOID FEVER
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SEEN WITH SALMONEALLA INFXN
Rose spots assoc. with intestinal fire |
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DERMATOMYOSITIS
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Heliotropic rash
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ERYSIPELAS
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Reddened area on skin w/ raised borders
DOES NOT BLANCH |
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TINEEA CRURIS
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Redness
Itchy groin |
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PITYRIASIS ROSEA
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Herald patch= dry skin patches that follow skin lines
HHV 7 |
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TINEA VERSICOLOR
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Hypopigmented macules on upper back
Presents in a V pattern A.K.A. upside down christmas tree Tx: Griseofulvin |
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What do you see in SCABIES?
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Linear excoriations on belt line and finger webs
What is the tx? Lindane Permethrin |
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What is a T-CELL DEFICIENCY?
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DiGeorges
What ion imbalance will they have? Hypokalemia What did not form? 3rd and 4th pharyngeal pouch What chromosome? Deletion on chromosome 22 |
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T-CELL DEFICIENCY
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HIV
Also B-cell but less so |
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What is MYCOSIS FUNGOIDES?
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NOT A FUNGUS
Non-Hodgkins form of cutaneous T-cell lymphoma |
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What is the job of CHYLOMICRONS?
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Transport TG’s from GI to liver and endothelium
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What is the job of VLDL?
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Transports TG’s from liver to adipose
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What is the job of IDL?
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Transports TG’s from adipose to tissue
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What is special about LDL’s?
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ONLY ONE THAT CARRIES CHOLESTEROL
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What do you develop with HYPERTRIGLYCERIDEMA?
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XANTHELASMA
Where are they located? On eyelids and eyebrows |
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What do you develop with HYPERCHOLESTEROLEMIA?
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Xanthomas
Where are they located? elbows |
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Where is VLDL made?
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ONLY ONE MADE IN THE LIVER
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What are IDL AND LDL formed from?
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ARE BREAK DOWN PRODUCTS OF VLDL
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What are the clues for HEMOPHILIUS INFLUENZA? Gram -/+?
What pattern? What type is most common? |
Gram -/+?
Pleomorphic gram (-) rods What pattern? “school of fish pattern” What type is most common? Type A 80% |
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What are the clues for HEMOPHILIUS INFLUENZA?
Invasive or non invasive? Capsule or no capsule? |
Capsule or no capsule?
non-encapsulated Invasive or non invasive? non-invasive |
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What are the clues for HEMOPHILIUS INFLUENZA? Most common cause of what?
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Most common cause of what?
Sinusitis Otitis Bronchitis |
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What are the clues for HEMOPHILIUS INFLUENZA?
What is the 2nd most common type? Encapsulated or non encapsulated? What does it have in there? |
What is the 2nd most common type?
TYPE B 20% Encapsulated or non encapsulated? Encapsulated What does it have in its capsule? Polyribosyl phosphate in capsule Contains IgA protease |
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What are the clues for HEMOPHILIUS INFLUENZA? Invasive or non invasive?
What does it cause most often? What are the signs of epiglottitis? |
Invasive or non invasive?
Invasive What does it cause most often? #1 cause of epiglottitis What are the signs of epiglottitis? Stridor Fever Thumb sign on xray |
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What are the most common causes of MENINGITIS corresponding with the following ages? 0-2 months?
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0-2 months?
#1. Group B strep (agalactiae) #2. E. coli #3. Listera |
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What are the most common causes of MENINGITIS corresponding with the following ages? 2 Months- 10 years? 10yrs- 21 yrs? > 21 years old?
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2 Months- 10 years?
#1. strep pneumonia #2. n. meningitides (adolescent years only) 10yrs- 21 yrs? #1. n. meningitides > 21 years old? #1 S. pneumoniae |
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Answer the following about the Strep. Pneumonia vaccine. At what age is it given?
What strain does it cover? |
At what age is it given?
Given at 2,4,6 months What strain does it cover? Covers 23 strains (98% cases) |
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Answer the following about the Strep. Pneumonia vaccine.
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Indications?
Anyone> 65y/o Anyone splenectomized Sickle cell anemia Anyone with end-organ damage CF RF Nephrotic Syndrome |
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STREP PYOGENES is the most common cause of what? #2 MCC of all what?
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MCC of all throat infections
#2 MCC of all what? Skin infections except lines |
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What are the STAPHYLOCOCCUS PIGMENTS? St. aureus?
St. epidermidis? St. saprophyticus? |
St. aureus?
Gold pigment St. epidermidis? White pigment St. saprophyticus? No pigment |
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What is the clue for RUSTY COLORED SPUTUM?
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Strep. Pneumonia
pneumococcus |
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Clues for GENERAL INFECTIONS
Skin Infections? Throat Infections? Small Intestine Infections? |
Skin Infections?
Say Staph. Aureus Throat Infections? Say Strep. Pyogenes Small Intestine Infections? Say E. coli |
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What disease is a NEUTROPHIL DEFICIENCY & T,B cell deficiency?
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Job Syndrome:
IL-4 Hyper IgE What do they look like? Red hair Fair complexion Female |
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What are the NEUTROPHIL DEFICIENCY?
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NADPH-OXIDASE DEF (CGD)
NEUTROPENIA MYLOPEROXIDASE Job-Buckley Syndrome |
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What Hepatitis B antigen is found with an acute/recent infection?
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HbC antigen
HbS antigen |
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What Hepatitis B antigen & antibody is found with an acute/recent infection?
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HbC antigen
HbS antigen HbC antibody |
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What Hepatitis B antigen is found with Recent immunization within the past 2wks?
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HbS antigen ONLY
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What Hepatitis B antibody is found with Recent immunization two wks after and can be due to vaccination immunity from a long time ago?
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HbS antibody ONLY
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What Hepatitis B antibody & antigen is found with past disease but now immune?
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HbC antibody
HbS antibody HbS antigen |
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What Immunogloblin is found in Hepatitis B immunity?
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IgG
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What Hepatitis B antigen/antibody is found in the chronic carrier state?
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HbS antigen for >6months
Can be with or without HbS antibody |
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What Hepatitis B antigen is found with the infectious state?
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HbE antigen
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What Hepatitis B antibody is found with the non-infectious state?
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HbE antibody
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If patient has recovered from Hepatitis B what antigen will they have?
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NEGATIVE HbS antigen
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If patient is a chronic carrier what antigen will they have?
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POSITIVE HbS antigen
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What does the “window period” build in Hepatitis B?
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HbE antibody
IgM HbC antibody What disappears? HbS antigen |
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What is the incubation period for Hepatitis B?
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4 to 26 wks
Average @ 8wks |
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How long is the acute disease period in Hepatitis B?
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4 to 12 wks
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How long is the convalescence period in Hepatitis B?
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4 to 20 wks
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How long is the recovery period for Hepatitis B?
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YEARS
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Answer the following about HIV?
MC infection? MCC of death? What is p41 used for? |
MC infection?
CMV MCC of death? PCP (Pneumocystis carinii Pneumonia) What is p41 used for? Just a marker |
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Answer the following questions about HIV?
What does Gp120 do? What is Pol used for? What is reverse transcriptase used for? What are p17 & p24 antigens used for? |
What does Gp120 do?
Attachment to CD4 What is Pol used for? Integration What is reverse transcriptase used for? Transcription What are p17 & p24 antigens used for? Assembly |
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Answer the following questions about HIV?
What is the normal CD4 count? What can the CD4 count be up to in children? When do you begin treating with 2 nucleotide inhibitors and 1 protease inhibitor? |
What is the normal CD4 count?
800-1200 What can the CD4 count be up to in children? 1500 When do you begin treating with 2 nucleotide inhibitors and 1 protease inhibitor? <500 (child at 750) |
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Answer the following questions about HIV? AIDS is defined as a CD4 count of what?
With a CD4 count of <200 what do you tx for? What do you treat for when CD count is <100? |
AIDS is defined as a CD4 count of what?
<200 With a CD4 count of <200 what do you tx for? PCP What do you treat for when CD count is <100? Mycobacterium aviam intracellular |
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What are the Antioxidants?
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Vitamin E
#1 Vitamin A Vitamin C Betakertine |
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What is Vitamin A a cofactor for? Along with what other cofactor?
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Parathyroid
Along with what other cofactor? Mg+ |
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Too much Vitamin A will cause what?
What will be the symptoms? |
Hyperparathyroid
Increase Ca+ Decrease Phosphate What will be the symptoms? Goans Moans Bones Stones |
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Too much Vitamin A will cause what?
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Pseudotumor Cerebri
Increase CSF production from Chorichoid Plexus |
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What is the only cause of ICP that does not cause herniation?
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Pseucotumor cerebri
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What does Vitamin A deficiency cause?
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Nightvision problems/nightblindness
Hypoparathyroidism Decrease Ca+ Increase Phosphate |
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What is Vitamin B1?
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THIAMINE
What do you get with a decrease in thiamine? Beri Beri What is the most common cause in US? ETOH |
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What do you get with Vitamin B1 deficiency?
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Wet Berry Berry
With heart failure Dry Berry Berry Without heart failure |
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What do you get with Vitamin B1 deficiency?
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Wernicke’s Encephalopathy
Wernicke’s Korsakoff |
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What is Wernicke’s Encephalopathy?
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Alcoholic thymine deficiency of the Temporal Lobe
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What needs B1 as a Cofactor?
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3 Dehydrogenases
Pyruvate dehydrogenase Alpha ketoglutarate dehydrogenase Branch chain amino acid dehydrogenase Transketolase |
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What is B2
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Riboflavin
What is a physical sign of this deficiency? Angular stomatitis Angular cheliosis Corneal Neurovasculazations |
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What is the best source of B2?
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Milk
Also from FAD |
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What is B3?
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Niacin
What is the clue? Diarrhea Dermatitis Dementia Death |
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What is the disease that presents like B3 deficiency?
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Hartnup Disease
What is deficient in this disease? Tyrptophan What is typtophan needed for? Needed for niacin formation |
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What is B4?
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Lipoic acid
What is the deficiency caused by this vitamin? Not one |
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What is B5?
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Pantothenic acid
What is the deficiency caused by this vitamin? You guessed it…nothing |
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What is B6?
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Pyridoxine
What is the deficiency caused by this vitamin? Neuropathy Seizures Who do you need to give B6 to? Patient on INH |
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What type of anemia is seen with B6 Deficiency?
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Sideroblastic
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What needs B6 as a cofactor?
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ALL transaminases
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What is B12?
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Cyanocobalamine
What is the deficiency caused by this vitamin? Pernicious anemia Neuropathy |
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What is the most common cause of vitamin B12 deficiency?
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Pernicious anemia
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What 2 enzymes are needed for synthesis of B12?
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Methylmalonyl CoA Mutase
Homocysteine Methyl Transferase |
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Deficiency in Methylmalonyl CoA Mutase leads to what?
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Neuropathy
Why? Because it recycles myelin |
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Deficiency in Homocystiene Methyl Transferase leads to what?
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Megaloblastic anemia
What else is this enzyme needed for? Nucleotide synthesis |
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When is ANGULARE STOMATOSIS seen?
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VITAMIN B2- RIBOFLAVIN deficiency
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What are the 4 D’S of pellegra?
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DIARRHEA
DERMATITIS DEMENTIA DEATH |
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What causes a NEUROPATHY WHEN DEFICIENT & also needs TRANSAMINASE?
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PYRIDOXINE B6
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What vitamin is deficient with PERNICIOUS ANEMIA & NEUROPATHY?
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B12 CYANOCOBALAMINE
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What is the first vitamin to run out with disease of rapidly dividing cells?
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Folate
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What type of anemia is seen with Folate deficiency?
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Megaloblastic anemia
With neuropathy? NO NEUROPHATHY What else is Folate used for? Nucleotide synthase (THF) |
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What is another name for Vitamin C?
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Ascorbate acid
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What is Vitamin C needed for?
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Collagen synthesis
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What happens with Vitamin C deficiency?
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Scurvy
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What is the CLUE for Scurvy?
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Bleeding gums
Bleeding hair follicles |
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What is the most common cause of Vitamin C deficiency?
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Diet deficient in citrus fruit
Diet deficient in green vegetables Over cooked green vegetables |
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What does Vitamin D do with Ca+?
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Controls Ca+
Absorbes Ca+ from GI Reabsorbs Ca+ in Kidneys Controls osteoblastic activity |
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What does Vitamin D deficiency cause in Children?
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Ricketts
What does it cause in ADULTS? Osteomalcia |
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What is the CLUE for RICKETTS?
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Lateral Bowing of the Legs
X-linked dominant |
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What is Vitamin E needed for?
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Hair
Skin Eyes Protection against free radicals #1 antioxidant |
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What does a deficiency of Vitamin E cause in newborns?
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Retinopathy
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What are the vitamins from GI that are normal flora?
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Folate
Vitamin K 90% Biotin Panothenic acid Helps with absorption of B12 |
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What are the Vitamin K dependent clotting factors?
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1972
Protein C Protein S Which one has the shortest half-life? Protein C Which one has the 2nd shortest half-life? 7 |
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What are the TRACE elements?
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Chromium
Selenium Manganese Molebdenum Tin |
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What is Chromium needed for?
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Insulin action
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What organ needs Selenium?
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Heart
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What trace element is an enzyme in glycolsis?
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Manganese Molebdenum
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What organ needs Tin?
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Hair
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What does a deficiency in Zinc cause?
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Dysguzia
Decrease sperm Dry hair Dry skin |
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Cofactor for ALL Kinases?
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Mg+
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Cofactor for ALL Carboxylases?
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Biotin
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Cofactor for ALL Transaminases?
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Pyridoxine
B6 |
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What is Biotin a cofactor for?
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ALL carboxylases
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What is Mg+ a cofactor for?
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ALL kinases
Parathyroid along with Vitamin A |
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What is Ca+ needed for?
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Muscle contraction
Axonal transport 2nd messengers |
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What tracts are affected due to deficiency in Methyl Malonyl CoA Mutase? Why are these affected?
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Dorsal Columns
Cortical Spinal Tracts Why are these affected? Because they are the longest Because they need the most myelin |
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What enzyme does Zanthein Oxidase need?
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Maganese Molebdenum
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How are drugs that are bioavailable ALWAYS excreted?
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By the liver
Always Hepatotoxic |
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How are soluble drugs ALWAYS excreted?
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By the kidney
Always nephrotoxic |
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What are the 5 P’S OF COMPARTMENT SYNDROME?
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Pain
Pallor Paresthesia Pulselessness Poikilothermia |
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What are 5 skin infections were Strep. Pyogenes is the number one cause?
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Lympangitis
Impetigo (not bullous) Necrotizing fascitis Erysepelas Scarlet fever |
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What are 5 skin infections were Staph. aureus is the number two cause?
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Lympangitis
Impetigo (not bullous) Necrotizing fascitis Erysepelas Scarlet fever |
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What is the #1 bacteria causing infection associated in shunts and central lines?
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Staph epidermitis
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What is the #1 bacteria causing infection in peripheral lines?
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Staph aureus
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Why do we need E. COLI in the gut?
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Absorption of Vit. B12
Synthesis of: -Vitamin K -Biotin -Folate -Pantothenic acid B5 |
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Answer the following questions about RESTRICTION ENZYMES? Trypsin cuts where?
Chymotrypsin cuts where? |
Trypsin cuts where?
cuts to R of Arg Lys Chymotrypsin cuts where? cuts to R of bulky aa’s (aromatics) Phe Tyr Trp |
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Answer the following questions about RESTRICTION ENZYMES? Elastase cuts where?
CNBr cuts where? |
Elastase cuts where?
Cuts to R of (“SAG”) Ser Ala Gly CNBr cuts where? Cuts to R of Methionine |
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Answer the following questions about RESTRICTION ENZYMES? Mercaptoethanol cuts where?
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Mercaptoethanol cuts where?
Cuts to R of: disulfide bonds Cysteine methionine |
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Answer the following questions about RESTRICTION ENZYMES? Aminopeptidase cuts where?
Caboxypeptidase cuts where? |
Aminopeptidase cuts where?
Cuts to R of amino acid terminal Caboxypeptidase cuts where? Cuts to L of carboxy terminal |
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What is THE ONLY LIVE VACCINE INDICATED IN AIDS PATIENTS?
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MMR
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What VACCINE is NOT GIVEN IF pt. is Allergic to EGG?
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MMR & INFLUENZA
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What VACCINE is NOT GIVEN IF patient HAS YEAST ALLERGIES?
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Hepatitis B
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What 3 VACCINES DROP OUT AFTER 6 YEARS OF AGE?
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Hib
Diphtheria Pertussis |
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What is the MC STRAIN OF STREP PYOGENES TO CAUSE GN?
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Strain 12
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What 2 substances are in NEUTROPHILS?
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Myeloperoxidase
NADPH Oxidase |
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MACROPHAGES CONTAIN what SUBSTANCE?
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NADPH Oxidase
Which means they only kill what? Kills only G -ve |
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What do MACROPHAGES SECRETE?
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IL-1
IL-6 |
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What DRUGS CAUSE PAINFUL NEUROPATHY?
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DDI>DDC
Pancreatitis |
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What are the MITOCHONDRIAL DISEASES?
What is another name? What are the signs & symptoms? What is the deficiency? |
Leigh’s Disease
What is another name? Subacute necrotizing encephalomyelopathy What are the signs & symptoms? Progressively decreasing IQ Seizure Ataxia What is the deficiency? Cytochrome oxidase deficiency |
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What are the MITOCHONDRIAL DISEASES?
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Leber’s Hereditary Optic Atrophy (LHON)
They all die |
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What is the ONLY G +ve WITH ENDOTOXIN? What part is toxic?
Does it cross the placenta? |
Listeria
What part is toxic? Lipid A Does it cross the placenta? Yes |
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What does Listeria activate?
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T-cells & Macrophages, therefore, have granulomas
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What are the Associations in contracting the Listeria bug?
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Raw cabbage
Spoiled milk Migrant workers |
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What are the PERIODS OF RAPID GROWTH/RAPIDLY DIVIDING CELLS?
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Birth – 2 months
4 – 7 years old Puberty |
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What is THE ONLY IMMUNE DEFICIENCY WITH LOW CALCIUM and Increase Phosphate?
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DiGeorge’s Syndrome
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What are the BASIC AMINO ACIDS?
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Lysine
Arginine |
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What are the ACIDIC AMINO ACIDS?
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Glutamate
Aspartate |
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What are the Ketogenic + Glucogenic Amino Acids?
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Phenylalanine
Isoleucine Trptophan Threonine |
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What are the AROMATIC AMINO ACIDS?
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Phenylalanin
Tyrosine Tryptophan |
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What are the AMINO ACIDS with DISULFIDE BONDS?
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Met
Cyst |
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What are the “KINKY” AMINO ACID?
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Proline
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What are the SMALLEST AMINO ACID?
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Gly
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What are the AMINO ACIDS with O-BONDS?
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Serine
Threonine Tyrosine |
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What are the AMINO ACIDS with N-BONDS?
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Asparagine
Glutamine |
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What are the BRANCHED-CHAIN AMINO ACIDS?
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Leu
Iso Val |
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What are the KETOGENIC AMINO ACIDS?
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Leu
Lys |
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What CONDITIONS are ASSOCIATED WITH HLA-B27?
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Psoriasis (with arthritis)
Ankylosing Spondylitis Irritable Bowel Syndrome Reiter’s Syndrome |
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What is associated with HLA-B13?
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Psoriasis with out arthritis
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What are the ORGANISMS WITH IgA PROTEASE (resistant to IgA)?
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Strep. Pneumoniae
H. influenza Neisseria catarrhalis |
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What do EOSINOPHILS SECRETE?
|
Histaminase
Arylsulfatase Heparin Major Basic Protein |
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What do MAST CELLS SECRETE?
In an Acute Reaction? In a Late Reaction ? |
In an Acute Reaction?
Histamine In a Late Reaction ? SRS-A ECF-A |
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What is the MCC of ATYPICAL PNEUMONIA?
0 – 2 months? |
0 – 2 months?
chlamydia pneumonia |
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What does chlamydia pneumonia cause?
|
Intersitital pneumonia
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What is the CLUE for HEART BLOCK?
|
High temperature with NORMAL pulse rate!
(This should never be! Each degree ↑ in temp. → 10 beats/min ↑ in pulse rate) |
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What are the clues for IL-1?
|
FEVER
NONSPECIFIC ILLNESS RECRUITS TH CELLS for LINKING with MHC II COMPLEX SECRETED BY MACROPHAGES |
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What are the clues for IL-2?
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MOST POTENT OF THE Interleukins
RECRUITS EVERYBODY MOST POWERFUL CHEMO-ATTRACTANT MUST BE INACTIVATED When must you inactivate it? PRIOR TO TRANSPLANTATION by cyclosporin SECRETED BY TH1 CELLS |
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What are the clues for IL-3?
|
ENERGIZED MACROPHAGES
CAUSES B-CELL PROLIFERATION LABELED BY THYMIDINE (USE POKEWEED MITOGEN OR ENDOTOXIN) SECRETED BY ACTIVATED T CELLS |
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What are the clues for IL-4?
|
B-CELL DIFFERENTIATION
RESPONSIBLE FOR CLASS SWITCHING SECRETED BY TH2 CELLS |
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What are the clues for IL-5 thru 14?
|
They do exactly what IL-1 thru IL4
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What are the clues for IL-10?
|
SUPPRESSES CELL-MEDIATED RESPONSE (tells macrophages and fibroblasts to stay away if bacterial)
INHIBITS MAC ACTIVATION |
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What are the clues for IL-12?
|
PROMOTES CELL-MEDIATED RESPONSE (recruits macs & fibroblasts if NOT bacterial)
ACTIVATES NK CELLS TO SECRETE IF-γ INHIBITS IL-4 INDUCED IgE SECRETION CHANGES TH CELLS to TH1 CELLS secretes IL-2 & IF-γ → inhib. TH2, therefore, ↑ host defenses against delayed hypersensitivity |
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What are the clues for IF-α?
|
Where is it from?
LEUKOCYTES ↓VIRAL REPLICATION AND TUMOR GROWTH ↑ NK ACTVITY secretes perforins and granzymes to kill infected cell ↑MHC CLASS I & II EXPRESSION ↓ PROTEIN SYNTHESIS translation inhibited, therefore, defective protein synthesis |
|
|
Summary of clues for IF-α?
|
Increase NK activity
Increase MHC class I & II Decrease protein synthesis Decrease viral replication and growth |
|
|
What are the clues for IF-B?
|
Where is it from?
FIBROBLASTS Increase NK activity Increase MHC class I & II Decrease protein synthesis Decrease viral replication and growth |
|
|
What are the clues for IF-gama?
|
Where is it from?
T-CELLS & NK CELLS ↑ NK ACTIVITY ↑MHC CLASS I & II ↑ MACROPHAGE ACTIVITY CO-STIMULATES B-CELL GROWTH & DIFFERENTIATION ↓ IgE SECRETION |
|
|
What are the clues for TNF-alpha?
|
Where is it from?
MONOCYTES & MACROPHAGES What is another name for TNF-alpha? CACHECTIN INDUCES IL-1 ↑ ADHESION MOLECULES & MHC CLASS I ON ENDOTHELIAL CELLS PYROGEN INDUCES IF-γ SECRETION CYTOTOXIC/CYTOSTATIC EFFECT |
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|
What are the clues for TNF-beta?
|
Where is it from?
T-CELLS What is another name for it? LYMPHOTOXIN CYTOTOXIC FACTOR |
|
|
What are the clues for TGF-α?
Where is it from? What is another name for it? |
Where is it from?
SOLID TUMORS (CARCINOMA > SARCOMA) MONOCYTES What is another name for it? TRANSFORMING GROWTH FACTORS |
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|
What are the clues for TGF-α?
What does it INDUCE? What is it mainly for? |
What does it INDUCE?
ANGIOGENESIS KERATINOCYTE PROLIFERATION BONE RESORPTION TUMOR GROWTH What is it mainly for? MAINLY FOR TUMOR GROWTH |
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|
What are the clues for TGF-β?
Where is it from? What INDUCES it? |
Where is it from?
PLATELETS PLACENTA KIDNEY BONE T & B CELLS What INDUCES it? FIBROBLAST PROLIFERATION COLLAGEN FIBRONECTIN SYNTHESIS |
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|
What are the clues for TGF-β?
What INHIBITS it? What ENHANCES it? |
What INHIBITS it?
NK LAK CTL T & B CELL PROLIFERATION What ENHANCES it? WOUND HEALING ANGIOGENESIS |
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|
What are the clues for TGF-β?
What does it suppress? What is it mainly for? |
What does it suppress?
SUPPRESSES IR AFTER INFECTION & PROMOTES HEALING PROCESS What is it mainly for? MAINLY FOR WOUND HEALING |
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|
What does LAK stand for?
|
LYMPHOKINE ACTIVATED KILLER CELLS
|
|
|
What does CTL stand for?
|
CYTOTOXIC T-LYMPHOCYTES
|
|
|
What does mitochondrial inheritance affect?
Why does it affect these particular places? |
CNS
Heart Skeletal muscle Why does it affect these particular places? Due to uneven cytokinesis during meiosis or oogenesis |
|
|
Answer the following about Mitochondrial diseases:
Who are affected? Who passes the disease? Who has no transmission? |
Who are affected?
All offspring Who passes the disease? MOM Who has no transmission? Dad |
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|
Answer the following about Autosomal Recessive inheritance:
Who does it show in? When is onset? Is it complete on incomplete penetrance? |
Who does it show in?
Not parents Siblings/uncles may show disease When is onset? Early in life (childhood diagnosis) Is it complete on incomplete penetrance? COMPLETE |
|
|
Answer the following about Autosomal Recessive inheritance:
How are they acquired? When does it occur? |
How are they acquired?
Almost ALL are inborn error of metabolism When does it occur? Only when both alleles at a locus are mutant |
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|
Answer the following about Autosomal Recessive inheritance:
How is it transmitted? Are there malformations present? What type of defect? |
How is it transmitted?
Horizontal Tm Are there malformations present? Physical malformations are uncommon What type of defect? Enzyme defect |
|
|
Answer the following about Autosomal Dominant inheritance:
Who does it affect the most? How does it manifest? Who can transmit the disease? Where is the new mutation? When is onset? |
Who does it affect the most?
M=F How does it manifest? Heterozygote state Who can transmit the disease? Both parents Where is the new mutation? Often in germ cells of older fathers When is onset? Often delayed (adult diagnosis) Example = Huntington’s |
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|
Answer the following about Autosomal Dominant inheritance:
What is penetrance? How is it expressed? How is it transmitted? Is there malformation present? What type of defect? |
What is penetrance?
Reduced penetrance How is it expressed? Variable expressin Different in each individual How is it transmitted? Vertical TM Is there malformation present? Physical malformation common What type of defect? Structural |
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|
Who is affected in the family with an X-Linked disease?
|
Maternal grandfather
Maternal uncle |
|
|
Immune System Time Line for viral & cell-mediated.
What happens <24hrs? What happens at 24 hrs? What happens at day 3? What happens at day 4? What happens at day 7? What happens in 1 month? What happens at 3-6 months? |
What happens <24hrs?
Swelling What happens at 24 hrs? Neutrophils show up What happens at day 3? Neutrophils peak What happens at day 4? T cells and Macrophages show up What happens at day 7? Fibroblasts show up What happens in 1 month? Fibroblast peak What happens at 3-6 months? Fibroblasts are gone |
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|
What is the general CLUE for any Lysosomal Storage Disease?
|
Lysosomal Inclusion Bodies
|
|
|
What are the Lysosomal Storage diseases?
|
Gauchers
Fabrys Krabbe Tay Sachs Sandhoffs Hurlers Hunters Neiman Pick Metachromatic Leukodystropy |
|
|
What is missing in Gauchers?
What Accumulates? Where? |
Beta-Glucocerberosidase
What Accumulates? Glucocebroside Where? Brain Liver Bone Marrow Spleen |
|
|
What are the CLUES for Gauchers?
|
Ask. Jew
Gargols Gaucher cells Macrophages looking like Crinkeled paper Erlin myoflask legs Pseudohypertrophy |
|
|
What is missing in Fabrys?
What accumulates? |
Alpha-galactosidase
What accumulates? Ceramide Trihexoside |
|
|
What are the CLUES for Fabrys?
|
X-Linked recessive
Presents with cataracts as a child Presents with renal failure as a child |
|
|
What is missing in Krabbes?
What accumulates? Where? |
Galactosylceramide B-Galactosidase
What accumulates? Galactocerebrosidase Where? Brain |
|
|
What are the CLUES for Krabbes?
|
Early death
Globoid bodies Fat cells |
|
|
What is missing in Tay Sachs?
What accumulates? |
Hexoseaminidase A
What accumulates? GM2 Ganglioside |
|
|
What is the CLUE for Tay Sachs?
|
Ask. Jews
Cherry red macula Death by 3 |
|
|
What is missing in Sandhoffs?
|
Hexoseaminadase A & B
|
|
|
What is missing in Hurlers?
|
Iduronidase
|
|
|
What are the CLUES for Hurlers?
|
Corneal Clouding
Mental Retardation |
|
|
What is missing in Hunters?
|
Iduronate Sulfatase
|
|
|
What are the CLUES for Hunters?
|
Mild mental retardation
No corneal clouding Mild form of Hurlers X-linked recessive |
|
|
What is missing in Niemann Picks? What accumulates?
|
Spingomyelinase
What accumulates? Spingomyelin Cholesterol |
|
|
What are the CLUES for Niemann Picks?
|
Zebra bodies
Cherrry red macula Die by 3 |
|
|
What is missing in Metachromatic Leukodystrophy?
|
Arylsulfatase A
|
|
|
What is the CLUE for Metachromatic Leukodystrophy?
|
Visual Disturbance
Presents like MS in 5 to 10 years of age |
|
|
What are the Glycogen Storage Diseases?
|
Von Gierkes
Andersons Corys McCardles Pompes Hers |
|
|
What is deficient in Von Gierkes?
|
G-6-Pase Deficiency
(Glucose 6-phosphatase) |
|
|
What is the CLUE for Von Gierkes?
|
Big Liver
Big Kidney Severe hypoglycemia Can NEVER raise their blood sugar |
|
|
What is deficient in Andersons?
|
Branching enzyme deficiency
|
|
|
What is the CLUE for Andersons?
|
Glycogen will be ALL LONG chains on liver biopsy
|
|
|
What is missing in Corys?
|
Debranching enzyme
|
|
|
What is the CLUE for Corys?
|
Glycogen from liver biopsy will be ALL SHORT branches
|
|
|
What is missing in McCardles?
|
Muscle phosphorylase
|
|
|
What is the CLUE for McCardles?
|
Severe muscle cramps when exercising
High CPK |
|
|
What is missing in Pompes?
|
Cardiac alpha-1,4 glucocydase
|
|
|
What is the CLUE for Pompes?
|
Heart problems
Die early |
|
|
What is missing in Hers?
|
Liver phosphoralase
|
|
|
What is the CLUE for Hers?
|
Big Liver
NO big kidney |
|
|
Pagets disease is associated with what cancer?
|
Intraductal Ca
|
|
|
What MUST you rule out with a decrease AVO2?
|
AV Fistula
Vasodilation |
|
|
What diseases have a cherry red macula?
|
Tay Sachs
Sandhoffs Niemann Pick |
|
|
What is translocation 9;22?
|
CML
|
|
|
What is translocation 11;22?
|
Ewing’s sarcoma
|
|
|
What is translocation 8;14?
|
Burketts lymphoma
|
|
|
What is translocation 14;18?
|
Follicular lymphoma
|
|
|
What are the causes of restrictive cardiomyopathy?
|
Sarcoid
Amyloid Hemochromatosis Cancer Fibrosis Thanks STAN!! |
|
|
What are the CLUES for Vasulitis or Intravascular Hemolysis?
|
Shistocytes
Burr cells Helmet cells |
|
|
What is the CLUE for Extravascular Hemolysis?
|
Splenomegaly
|
|
|
Where is Glucose 6-Pase present?
|
Adrenal
Liver |
|
|
What is the Heinz body CLUE?
|
G6PD
|
|
|
If you see the CLUE basophilic stippling, what should you be thinking?
|
Lead poisoning
|
|
|
What are the Microcytic Hypochromic Anemias?
|
Iron deficiency
Anemia of Chronic disease Lead poisoning Hemoglobinopathy Thallasemia’s Sideroblastic anemia |
|
|
What is primary sideroblastic anemia due to?
|
Genetic
AD |
|
|
What is secondary Sideroblastic anemia due to?
|
Blood transfusions
|
|
|
What are the Microcytic Hyperchromic Anemia’s?
|
Hereditary Spherocytosis
|
|
|
What are the Normocytic Normochromic Anemia’s?
|
Acute hemorrhage
Anemia of Chronic Disease Hypothyrodism Early Renal Failure |
|
|
What are the Macrocytic anemia’s?
|
Folate deficiency
B12 deficiency Reticulocytosis ETOH Hemolytic Anemias Chemo Treatment Anticonvulsants Myelodysplasia |
|
|
What are the anticonvulsants causing a Macrocytic Anemia?
|
Phenytoin
Ethusuximide Carbamyazapine Valproate |
|
|
What anemia is caused by blood transfusions?
|
Sideroblastic anemia
|
|
|
What is the problem if you see Eliptocytes?
|
Something is wrong with the RBC membrane
Extravascular Heridatary Ellitocytosis Increased RET count |
|
|
What disease do you get if you have an EXCESS in Cu+?
|
Wilson’s Disease
|
|
|
What is the CLUE for Wilson’s Disease?
|
Hepato/Lenticular Degeneration
Kayser Fleishner Rings Copper in eyes Hepato = Liver Lenticular = Movement problem |
|
|
What is Copper needed for?
|
Collagen synthesis
|
|
|
What disease manifest with Cu+ deficiency?
|
Minky Kinky Hair Syndrome
|
|
|
What are the plasma catecholamines?
|
Epinephrine
Norepinephrine Dopamine |
|
|
What are Plasma Catecholamines derived from?
|
Tyrosine
|
|
|
A patient with episodic HTN leading to headache with arrhythmias leading to palpitations most likely is diagnosed with?
|
Adrenal Pheochromocytoma
|
|
|
What is the MOA for Fluoroquinolones?
|
Blocks DNA gyrase (topoisomerase II)
Inhibits p450 |
|
|
What do Fluoroquinolones cover?
|
All Gram + including staph auerus
All Gram – Atypicals |
|
|
What are the atypicals?
|
Chlamydia
Ureoplasma Mycoplasma Legionella |
|
|
What induces Gluconeogensis?
|
Cortisol
Epinephrine Glucagon |
|
|
What is Dermatan Sulfate?
|
Glycosaminoglycan chain that helps form proteoglycans
|
|
|
What is Hyaluronic Acid?
|
Glycosaminoglycan chain that helps form proteoglycans
|
|
|
What is the MOA of Methotrexate?
|
Inhibits dihydrofolate reductase
Inhibits DNA synthesis in the S phase of cycle. Prevents reduction of folic acid needed to produce THF |
|
|
What are THF derivatives used in?
|
Purine nucleotide synthesis
Methylation of dUMP to for dTMP |
|
|
What happens when Dihydrofolate Reductase is inhibited?
|
Obstructs one carbon methylation which deprives DNA polymerase of essential substrates
|
|
|
What diseases present as Failure to Thrive?
|
CF
Galactosemia |
|
|
In general, what should you always associate Hemolytic Anemia’s with?
|
Defects in Glycolysis
Defects in Hexose Monophosphate Shunt |
|
|
What is required for the conversion of Homocysteine to Methionine?
|
B12
|
|
|
What is required for the conversion of methylmalonyl CoA to Succinyl CoA?
|
B12
|
|
|
What is required for the degradation of cystathionine?
|
Vitamin B6
|
|
|
What does the hydroxalation of Purines require?
|
Vitamin C
|
|
|
When does the carboxyalation of Glutamic acid occurs and what is required for this carboxyalation?
|
Occurs in the synthesis of Blood Clotting factors
Requires Vitamin K |
|
|
Decarboxylation of alpha-ketoacids requires what?
|
Thiamine
|
|
|
Synthesis of 1,25-d-hydroxycholecalciferol requires what?
|
Vitamin D
|
|
|
Synthesis of Rhodopsin requires what?
|
Vitamin A
|
|
|
Pyruvate Decarboxylase requires what as a cofactor?
|
Thiamine
|
|
|
What is CN1?
What is its function? What if lesioned? Where does it Exit/Enter the Cranium? What does it innervate? |
Olfactory
What is its function? Sensory for smell What if lesioned? Anosmia Where does it Exit/Enter the Cranium? Cribriform plate What does it innervate? Nasal Cavity |
|
|
What is CN2? What is its function?
What if lesioned? Where does it Exit/Enter the Cranium? What does it innervate? |
Optic
What is its function? Sensory for sight What if lesioned? Anopsia Visual field defect Loss of light reflex with CN III Only nerve affected by MS Where does it Exit/Enter the Cranium? Optic Canal What does it innervate? Orbit |
|
|
What is CN3? What are the functions? What if lesioned?
Where does it Exit/Enter the Cranium? What does it innervate? |
Occulomotor
What are the functions? Motor Moves the eyeball in ALL directions Adduction Most important action (MR) Constricts the pupil (Spincter Pupillae) Accomodates (Cililary Muscle) Raises eyelid (Levator Palpebrae) What if lesioned? Diplopia Loss of parallel gaze Dilated pupil Loss of light reflex Loss of near response Ptosis Where does it Exit/Enter the Cranium? Superior Orbital Fissure What does it innervate? Orbit |
|
|
What is CN 4? What is its function?
What if lesioned? Where does it Exit/Enter the Cranium? What does it innervate? |
Trochlear
What is its function? Motor Superior Oblique Depresses and abducts the eyeballs Intorts What if lesioned? Weakness looking down w/ adducted eye Trouble going down stairs Head tilts away from lesioned side Where does it Exit/Enter the Cranium? Superior Orbital Fissure What does it innervate? Orbit |
|
|
What is CN 5? What are the different branches of CN 5?
|
Trigeminal
V1? Opthalmic V2? Maxillary V3? Mandibular |
|
|
What is the function of CN V1?
What if lesioned? Where does it Exit/Enter the Cranium? What does it innervate? |
Mixed
General sensation (touch, pain, temperature) of the forehead, scalp, & cornea What if lesioned? Loss of general sensation of the forehead/scalp Loss of blink reflex w/ VII Where does it Exit/Enter the Cranium? Superior orbital Fissure Ophthalmic division What does it innervate? Orbit Scalp |
|
|
What is the function of CN V2? What if lesioned? Where does it Exit/Enter the Cranium?
What does it innervate? |
Mixed
General sensation of Palat, Nasal cavity, Maxillary face, and Maxillary teeth What if lesioned? Loss of general sensation in skin over maxilla & maxillary teeth Where does it Exit/Enter the Cranium? Foramen Rotundum What does it innervate? Pterygopalatine Leaves by openings to face, oral & nasal cavity |
|
|
What is the function of CN V3?
What if lesioned? Where does it Exit/Enter the Cranium? What does it innervate? |
Mixed
General sensation of anterior 2/3 of tongue, mandibular face & mandibular teeth Motor Muscles of Mastication and anterior belly of digastric, mylohyoid, tensor tympani, tensor palati What if lesioned? Loss of general sensation in skin over mandible, mandibular teeth, tongue, weakness in chewing Jaw deviation to weak side Trigeminal neuralgia Intractable pain in V2 or V3 territory Where does it Exit/Enter the Cranium? Foramen Ovale What does it innervate? Infratemporal Fossa |
|
|
What is CN VI? What is its function?
What if lesioned? Where does it Exit/Enter the Cranium? What does it innervate? |
Abducens
What is its function? Motor Lateral rectus Abducts eye What if lesioned? Diplopia Internal strabismus Loss of parallel gaze Pseudoptosis Where does it Exit/Enter the Cranium? Superior orbital fissure What does it innervate? Orbit |
|
|
What is CN VII? What is its function? What if lesioned?
|
Facial
What is its function? Mixed To muscles of facial expression Posterior belly of diagastric Stylohyoid & Stapedius Tastes anterior 2/3 of tongue/palate Salivates (submandibular & sublingual glands) Tears (Lacrimal glands) Makes mucous (nasal & palatine glands) What if lesioned? Corner of mouth droops Can’t close eye Can’t wrinkle forehead Loss of blink reflex Hypeacusis Loss or alteration of taste (ageusia) Eye dry and red Bell Palsy - Lesion of nerve in facial canal |
|
|
Cont. CN VII : Where does it Exit/Enter the Cranium?
What does it innervate? |
Where does it Exit/Enter the Cranium?
Internal Auditory meatus What does it innervate? Face Nasal & oral cavity Branches leave skull in stylomastoid foramen, petrotympanic fissure, or Hiatus of facial canal |
|
|
What is CN VIII? What is its function?
What if lesioned? Where does it Exit/Enter the Cranium? What does it innervate? |
Vestibulocochlear
What is its function? Sensory Hears Linear acceleration (Gravity) Angular acceleration (Head Turning) What if lesioned? Loss of Balance Nystagmus Where does it Exit/Enter the Cranium? Internal Auditory Meatus What does it innervate? Inner ear |
|
|
What is CN IX? What is its function? What if lesioned?
Where does it Exit/Enter the Cranium? What does it innervate? |
Glossopharyngeal
What is its function? Mixed Sense Pharynx Carotid sinus/body Salivates (parotid glands) Tastes and senses posterior 1/3 of tongue !!!To one muscle only (stylopharyngeus) What if lesioned? Loss of Gag Reflex with X Where does it Exit/Enter the Cranium? Jugular Foramen What does it innervate? Neck Pharynx/Tongue |
|
|
What is CN X? What is its function? What if lesioned?
|
Vagus
What is its function? Mixed To muscles of palate & pharynx for swallowing except tensor palate (V) & Stylopharynegeus (IX) To all muscles of Larynx (phonates) Senses Larynx & Laryngopharynx Senses Larynx & GI tract To GI tract smooth muscle & glands in forgut & midgut What if lesioned? Nasal speech Nasal regurgitation Dysphagia Palate drop Uvula points away from pathology Hoarseness/fixed vocal cord Loss of gag reflex w/ IX Loss of cough reflex |
|
|
Cont. CN X: Where does it Exit/Enter the Cranium?
What does it innervate? |
Where does it Exit/Enter the Cranium?
Jugular Foramen What does it innervate? Neck Pharynx/Larynz Thorax/Abdo |
|
|
CN X – Sympathetics to Head: What is its function? What if lesioned?
|
What is its function?
Motor Raises eyelid (superior tarsal muscle) Dilates pupil Innervates sweat glands of face & scalp Constricts blood vessels in head What if lesioned? Horner syndrome Eyelid droop (ptosis) Constricted pupil (miosis) Loss of sweating (anhydrosis) Flushed face |
|
|
Cont. CN X- Sympathetics to Head: Where does it Exit/Enter the Cranium? What does it innervate?
|
Where does it Exit/Enter the Cranium?
Carotid canal on internal carotid artery What does it innervate? Orbit Face Scalp |
|
|
What is CN XI? What is its function? What if lesioned?
Where does it Exit/Enter the Cranium? What does it innervate? |
Accessory
What is its function? Turns head to opposite side sternocleidomastoid Elevates & Rotates scapula Trapezius What if lesioned? Weakness turning head to opposite side Shoulder droop Where does it Exit/Enter the Cranium? Jugular Foramen What does it innervate? Neck |
|
|
What is CN XII? What is its function?
What if lesioned? Where does it Exit/Enter the Cranium? What does it innervate? |
Hypoglossal
What is its function? Moves tongue What if lesioned? Tongue points toward pathology on protrusion Where does it Exit/Enter the Cranium? Hypoglossal Canal What does it innervate? Tongue |
|
|
What are the muscles of mastication?
|
Temporalis
Masseter Medial Pterygoids Lateral Pterygoids |
|
|
What part of the brain deals with problem solving?
|
Frontal Lobe
|
|
|
What happens if there is a lesion to the Optic nerve?
|
Unilateral Blindness
|
|
|
What happens if there is a lesion to the Optic Chiasm?
|
Bitemporal Hemianopia
|
|
|
Bitemporal Hemianopia
|
SUBARACHNOID Hemorrhage
|
|
|
What is a CLUE for SUBARACHNOID Hemorrhage?
|
The worse headache of my life
|
|
|
What effect does Pernicious Anemia have on the nervous system?
|
Causes degeneration of the posterior columns
Causes degeneration of the CST Loss of proprioception Upper motor neuron defect |
|
|
What does the diencephalon originate from?
|
Forebrain
|
|
|
What originates from the Diencephalon?
|
Thalamus
3rd Ventricle |
|
|
Where does the Telencephalon originate from?
|
Forebrain
Prosencephalon |
|
|
What originates from the Telencephalon?
|
Cerebral Hemispheres
Lateral Ventricles |
|
|
What originates from the Mesencephalon?
|
Midbrain
Aqueduct |
|
|
What originates from the Hindbrain?
|
Metencephalon
Myerencephalon |
|
|
What originates from the Metencephalon?
|
Pons
Cerebrum |
|
|
What originates from the Myencephalon?
|
Medulla
|
|
|
What does the Jugular Foramen contain?
|
CN IX
CN X CN XI Internal Jugular Vein Spinal accessory nerves |
|
|
What does the Foramen Spinosum contain?
|
Middle menningeal artery
Branch of the maxillary artery |
|
|
What does the Foramen Ovale contain?
|
CN V3
|
|
|
What does the Foramen Magnum contain?
|
Vertebral arteries
Brain stem Spinal roots of CN XI Spinal cord |
|
|
What does the Optic Canal contain?
|
Opthalmic artery
Central retinal vein CN II |
|
|
What does the Hypoglossal Canal contain?
|
CN XII
Hypoglossal nerve |
|
|
What does the Carotid Canal contain?
|
Internal Carotid artery
|
|
|
What does the Posterior Condylar Canal contain?
|
Large Emissary Vein
|
|
|
What are signs of an UPPER motor neuron damage?
|
+ Babinski sign
Spastic Paralysis Hyperactive Deep Tendon Reflexes |
|
|
What are signs of a lower motor neuron defect?
|
Atrophy
Fasciullations Flaccid Paralysis Loss of deep tendon reflexes |
|
|
What does it mean to see a physis on radiograph?
|
Means the skeleton is not fully mature
|
|
|
When does Physis disappear?
|
Once growth is complete
|
|
|
What is a nonunion fracture?
|
Fracture that does not heal with in 6 months
|
|
|
What does Malunion mean?
|
A fracture that heals in an Abnorman position
|
|
|
What is a characteristic feature of cancellous (spongy) bone?
|
Trabeculae
|
|
|
Which CN’s control eye movement?
|
CN III
Oculomotor nerve CN IV Trochlear nerve CN VI Abducens nerve |
|
|
What CN is responsible for turning the head and shrugging the shoulders?
|
CN XI
Accessory nerve |
|
|
What CN has sensory fibers for Face and Motor fibers for muscles of mastication?
|
CN V
Tigeminal Nerve |
|
|
What CN controls tongue movement?
|
CN XII
Hypoglossal nerve |
|
|
What CN controls sensory fibers for Vison
|
CN II
Optic nerve |
|
|
What CN senses fiber for smelling?
|
CN I
Olfactory |
|
|
What does the Mesenteric Artery Supply?
|
Distal 1/3 of transverse colon
Descending colon Sigmoid colon Upper Portion of Rectum |
|
|
What does the Superior Mesenteric Artery Supply?
|
Duodenum
Jejunum Ileum Cecum Appendix Ascending colon Proximal 2/3 of transverse colon |
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What does the common Iliac artery supply?
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Pelvis
Perineum Leg |
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What does the Celiac trunck give rise to?
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Left gastric artery
Splenic artery Common hepatic artery |
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What do the Left. Gastric Artery, Splenic Artery, & Common Hepatic artery supply?
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Esophagusa
Stomach Duodenum Liver Gallbladder Pancreas |
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If there is a lesion in the frontal lobe will you have motor or sensory defects?
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Motor
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If patient has a visual field defect with cognitive Distrubance, what part of the brain will be affected?
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Temporal or Partial Lobe
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