Ppal99 Dissecting The Usmle 1,2,3 Granulocytes

Front 1

what are the granulocytes and their normal levels?

Back 1

"Never Let Mom Eat Beans"
Neutrophils: 60%
lymphocytes: 30%
Monocytes: 8%
Eosinophils: 2%
• Basophils/Bands: < 1%

Front 2

what should we worry about if neutrophils are <2500?

Back 2

(< 2500 =>worry about Staph/Pseudo- or fungs if fever persists)

Front 3

Describe gram + bacteria
what attracts the PMNs
toxin
what makes you very sick?

Back 3

>Thick peptidoglycan wall - attracts PMNs
>Exotoxin (heat stable and unstable)
>Have teichoic acid (not toxic) => they can't make you very sick

Front 4

2 types of gram + exotoxin

Back 4

Heat stable
Heat unstable

Front 5

Heat stable gram + exotoxin

Back 5

can travel through bloodstream, cause sepsis

Front 6

Heat unstable gram + exotoxin

Back 6

can't travel through the bloodstream

Front 7

which gram + bug who does not have an exotoxin?

Back 7

Listeria

Front 8

unique features of a Gram (-) bug
describe the wall, membrane, toxins, gram stain

Back 8

• Thin PG wall
Outer membrane
May have capsule
Endotoxins: Lipid A, O Ag, Core Ag)
stains red

Front 9

gram (-): outer membrane has what space

Back 9

periplasmic space

Front 10

what are the gram (-) endotoxins

Back 10

Lipid "A"
O Ag
Core Ag

Front 11

Lipid "A"

Back 11

(same for all bugs)- toxic part=> sepsis (part of LPS)

Front 12

O Ag

Back 12

(different for every family) Ex: E.coli 0157 Jack-in-the-box EHEC strain

Front 13

Core Ag

Back 13

(different for every family member) "Core = who "Core = who you are individually"

Front 14

why does a patient get worse with first antibiotics? what is the prevention for this?

Back 14

>>If outer membrane destroyed ⇨ release- endotoxin⇨ pt gets worse at first w / antibiotics.
>>Give dexamethasone before antibiotics to prevent complications of bacterial meningitis

Front 15

what bug can release toxin while it's still growing?

Back 15

Only Neisseria

Front 16

How to make a gram stain:
what color is positive? negative?

Back 16

Crystal violet- binds peptidoglycan=> stains Gram+ purple "Positive = Purple"
Iodine; - seals it in
• Wash excess away w/ EtOH • Red Saffranin =>stains Gram ( - )red

Front 17

what stain is used for Acid Fast bacterias
what part of the bug is stained
what is positive? negative?

Back 17

Ziehl-Neelson stain:
stains mycolic acid
=> pathogen is pink (otherwise= blue)

Front 18

only Acid fast bug

Back 18

Mycobacteria

Front 19

what does Partially acid fast mean?
examples

Back 19

"Not Concise."
Nocardia and Cryptosporidia

Front 20

Gram+ partially acid fast bug:
what does it attack?

Back 20

Nocardia
(attacks diabetic lungs/sinus)

Front 21

acid fast bug and watery diarrhea. Dx
type of bug
where does it hide?
presentation

Back 21

Protozoan:
Cryptosporidia (stored in intestinal brush border)
=> watery diarrhea in AIDS

Front 22

Extreme Eosinophilia:

Back 22

''NAACP"
Neoplasm (lymphoma)
Allergy
Addison's disease (no cortisol => relative eosinophilia)
collagen vascular disease
parasites

Front 23

what cell is responsible for the Allergic Response?

Back 23

Mast Cells

Front 24

1st Date of antigen, how does the body react?

Back 24

Body doesn't react => it makes IgE => binds mast.

Front 25

2nd Date w/ Ag:

Back 25

IgE (Fab portion) binds Ag, crosslinks =>release:
Histamine
SRS-A
ECF-A

Front 26

The Allergic Response:
what causes Rubor: red, Calor: heat,
Dolor: pain, Tumor: swell up?
tx

Back 26

Histamine
(Tx: Histaminase)

Front 27

SRS-A:
what it stands for
what compund is it
tx
function

Back 27

>>Slow Rxn Substance for Anaphylaxis = Leukotriene C4,D4,E4
>>(Tx: Arylsulfatase)
>>potent bronchoconstrictor

Front 28

ECF-A: what it stands for and tx

Back 28

Eosinophil Chemotactic Factor of Anaphylaxis (Tx: Heparin)

Front 29

what cell release histaminase, aryl sulfatase, and heparin?

Back 29

Eosinophils

Front 30

how do we stain Mast Cells?

Back 30

Giemsa stain

Front 31

1st Gen Anti-histamines: H1 receptor blockers: symptoms and MOA

Back 31

anti-cholinergic (Hot, dry skin)

Front 32

H1 receptor blockers: name 6 them

Back 32

Diphenhydramine "Benadryl"
Dimenhy-drinate "Dramamine"
Meclizine
Hydroxyzine
Phenylpropanolamine
Phentermine

Front 33

Dimenhydrinate "Dramamine"

Back 33

tx motion sickness

Front 34

Meclizine

Back 34

best to tx vertigo

Front 35

Hydroxyzine

Back 35

tx stress-induced hives

Front 36

Phenylpropanolamine

Back 36

taken off market b/c of arrhythmias

Front 37

Phentermine

Back 37

taken off market b/ c of pulmonary and cardiac fibrosis

Front 38

2nd Gen Decongestant:
MOA
name (2)
which one is sudafed?
tx and what is it used for?
which one is the OTC?

Back 38

α agonists
• Pseudoephedrine "Sudafed"
tx stress incontinence, used to make methamphetamine
• Ephedrine - OTC

Front 39

Pseudoephedrine "Sudafed"
treatment
what is it use for?

Back 39

2nd Gen Decongestan (alpha agonist)
tx stress incontinence, used to make methamphetamine

Front 40

Ephedrine

Back 40

2nd Gen Decongestan
OTC

Front 41

3rd Gen Anti-histamines:
MOA
how many times per day is it taken?
and SE

Back 41

H 1 receptor blockers => 1 per day, less sedating

Front 42

name all 7 the 3rd Gen Anti-histamines

Back 42

Terfenadine
Loratidine
Desloratidine
Citirizine
Fexfenodine
Astemazole
Citirazine

Front 43

Terfenadine

Back 43

taken off market b/c of Torsade w/ macrolides

Front 44

Loratidine

Back 44

good for outdoor allergies

Front 45

Citirizine

Back 45

good for indoor/ outdoor allergies

Front 46

Fexfenodine

Back 46

good for indoor/ outdoor allergies