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;
121 Cards in this Set
- Front
- Back
|
How can you have 1 antibody, but not another?
|
T /B cell interaction.
|
|
|
what is needed for T/B cell interaction?
|
IL-4
Class switching CD-40: receptor Tyr kinase |
|
|
what do T cell deficiencies die of?
give 2 examples |
die of viral infection
DiGeorge Syndrome Chronic Mucocutaneous Candidiasis: |
|
|
DiGeorge Syndrome: pathogenesis and clue
|
3rd/ 4th
pharyngeal pouch⇨no thymus, inf. parathyroids⇨ ⇩Ca2+ • Only T -cell deficiency with an electrolyte problem |
|
|
Chronic Mucocutaneous Candidiasis
|
T cells can't kill Candida albicans ⇨chronic fatigue.
|
|
|
Steroids: MOA
|
• Kills T cells and eosinophils
• Inhibits macrophage migration • Stabilizes mast cell membranes • Stabilizes endothelium • Inhibits Phospholipase.A • Proteolysis • Gluconeogenesis • Upregulates all receptors during stress |
|
|
Betamethasone
function route of administration |
inhaled, induces surfactant
|
|
|
Beclomethasone
function |
induces surfactant
|
|
|
Danazol: tx
|
tx endometriosis
|
|
|
Dexamethasone
unique function what does it prevent treatment (2) |
best CNS penetration
tx cerebral edema tx meningitis (prevents inflamm) |
|
|
Fludrocortisone
|
best mineralcorticoid (acts like Aldo)
|
|
|
Fluticasone
mode of administration |
nasal spray
|
|
|
Methylprednisolone
mode of administration |
IV
|
|
|
Mometasone
mode of administration |
nasal spray
|
|
|
Megestrol is used for what?
|
tx appetite loss in cancer pts
|
|
|
Prednisone
mode of administration |
oral
|
|
|
Triamcinalone
mode of administration |
inhaled
|
|
|
Hydrocortisone
mode of administration |
topical and injectable
|
|
|
Cyproterone is a treatment for what disease?
|
prostate cancer
|
|
|
Cyclosporine: MOA and SE
|
MOA: blocks T cell function via calcineurin ⇨can't produce IL
SE: Gingival hyperplasia, hirsutism, renal failure (PCT) |
|
|
Tacrolimus
|
less side effects than cyclosporine
|
|
|
Hairy Cell Leukemia:
what indicates a good prognosis? appearance translocation stain tx |
• Fried egg, "sunburst" appearance
• t (1:19) indicates good prognosis • TRAP+ "Trap the hairy fried eggs" • Tx: Cladribine |
|
|
indication for good prognosis in hairy cell leukemia
|
t (1:19) ~> good prognosis
|
|
|
what are the 2 T -Cell Lymphomas:
|
• Mycosis Fungoides
• Sezary Syndrome |
|
|
Mycosis Fungoides
|
T -Cell Lymphoma, rash
|
|
|
Sezary Syndrome
|
T -Cell Lymphoma, found in blood
(indented cell membrane = "crenation!') |
|
|
what do B cell deficiencies die of?
|
die of bacterial infection
|
|
|
what are the 8 B cell deficiencies?
|
Bruton's Agammaglobulinemia
CVID: Leukemias/Lymphomas Plasmacytomas Multiple Myeloma Heavy Chain disease Selective IgA deficiency Selective IgG2 deficiency |
|
|
Bruton's Agammaglobulinemia
inheritance pathogenesis infection |
(XL): kids w / defective Tyr kinase, arrest at pre-B stage no Ab
• B cell count is normal, but function is lacking • Lung/ sinus infection |
|
|
what can stimulate B cells?
|
Pokeweed mitogen
Endotoxin |
|
|
CVID
|
Bruton's with onset after 1 y/o
|
|
|
Leukemias/Lymphomas
|
usually involve B cells
|
|
|
Plasmacytomas
|
one osteolytic lesion
|
|
|
Multiple Myeloma
lesions Ig, light chain type of CA blood smear tx |
multiple osteolytic lesions, IgG (M-spike), mu light chain (Bence-Jones proteinuria),
plasma cell CA, rouleaux (Tx: Melphalan) |
|
|
Heavy Chain disease:
|
IgA and Multiple Myeloma of GI tract, malabsorption
"Gee, I Am so Heavy" |
|
|
Selective IgA deficiency:
define management succeptible infections |
transfusion-related anaphylaxis (use IgA filter, lung/GI infections)
|
|
|
Selective IgG2 deficiency:
|
recurrent encapsulated infections
|
|
|
Encapsulated Organisms Gram (+):
|
Strep pneumo
|
|
|
Encapsulated Organisms Gram (-):
|
"Some Killers Have Pretty Nice Capsules"
Salmonella Klebsiella H. influenza B pseudomonas Neisseria Citrobacter |
|
|
Job-Buckley: clue, pathogenesis and signs and sx
|
common in redhead females w/ fair skin
• Class switch problem=> stuck in IgE stage • Recurrent Staph infection |
|
|
Common Variable Hypogammaglobulinemia (CVID):
|
young adults w/ B cells don't differentiate into plasma
cells |
|
|
what are the T and B cell deficiencies:
|
Ataxia Telangiectasia
SCID Wiscott-Aldrich |
|
|
Ataxia Telangiectasia: pathogenesis and presentation
|
DNA endonuclease defect
• Ataxia (wheelchair-bound), thymus hypoplasia, recurrent sinus infections |
|
|
SCID:
pathogenesis/life expectancy presentation Tx |
(no adenosine deaminase) =>baby dies by 2y/o
"frayed" long bones no thymus/LN Tx: bone marrow transplant |
|
|
Wiscott-Aldrich
mode of inheritance pathogenesis presentation (4) |
(XL)
⇩IgM/platelets eczema, petechiae, ⇧lymphoma, lung infections |
|
|
how does HIV infect cells
|
HIV is the only virus that does not penetrate cells, it injects its RNA into cells
|
|
|
HIV: pathogenesis
|
RNA retrovirus looks for CD4 receptors
inhibits proofreading likes acidic medium HIV invades TH and kills them |
|
|
what are the two receptors that HIV uses to attach to the cell
|
CCR4/5 mutation on CD4 cell => HIV can't attach to inject virus into cell
|
|
|
why do HIV patients are prone to CNS lymphoma, vasculitis and infections of the genitalia?
|
CD4 receptors:
o Blood vv=> vasculitis / Kaposi's sarcoma ("violaceous" nodules/HSV-8) o Brain=> CNS lymphoma o Genitalia: testicles, cervix, rectum |
|
|
where is the HIV reservoir:
|
Lymph node germinal centers (follicular dendritic cells)
|
|
|
what are the Fastest growing HIV populations and why?
most common form of HIV transmission who has the lowest risk? |
o Heterosexual black females (risk factor: bisexual male)
o Elderly - due to greater detection of past infxn o More common: Male => Female (HIV likes mucosa) o Lowest risk: pubertal female (don't have acidic mucosa) |
|
|
Cancers Common in HIV:
|
cervical cancer- very aggressive
Kaposi's sarcoma CNS Lyphoma Testicular Lymphoma |
|
|
5 HIV Vaccinations
|
• dT
• Hep A/B • Influenza • Pneumovax • MMR (B cells worK) |
|
|
what is the function of HIV Protein GP41?
|
portal for entry for RNA
|
|
|
what is the function of HIV Protein
GP 120? |
attachment to CD4 receptor
|
|
|
what is the function of HIV Protein
Pol |
Integration into our DNA
|
|
|
what is the function of HIV Protein CCR5
|
entry into cell
|
|
|
what is the function of HIV Protein
Reverse transcriptase |
Transcription/replication
|
|
|
what is the function of HIV Protein
P17? |
Assembly
|
|
|
what is the function of HIV Protein P24?
|
Assembly
|
|
|
how is HIV Transmitted?
|
sex, blood, Mom (pregnancy /breast milk)
|
|
|
AIDS definition
|
CD4 <200/μL or clinical sx
|
|
|
what are the HIV screening test?
|
1) ELISA: detect IgG Ab to p24 Ag (develops 1 mo after exposure)
2) Western Blot: must see at least 2 proteins 3) PCR: use -if <18 mo (b/c mom's IgG will make ELISA positive)- detects viral RNA |
|
|
when did HIV screening began?
|
began in 1985
|
|
|
what is the most specific acute infection in HIV?
|
oral ulcers
|
|
|
HIV Infections:encephalitis
|
Acanthamoeba
|
|
|
HIV Infections:bacillary angiomatosis
|
Bartonella Henselae: (pathognomonic for AIDS)
|
|
|
HIV Infections:
white eye lesions tx |
Candida: (Tx: Amphotericin B/Flucytosine) =>lifetime Fluconazole
|
|
|
HIV Infections: red umbilicated papules( Dx and mngmnt), meningitis
|
Cryptococcus: red umbilicated papules (do biopsy), meningitis
|
|
|
HIV Infections: watery diarrhea
|
Cryptosporidia: partial acid fast
|
|
|
HIV Infections:
big shallow esophageal ulcers bloody diarrhea, yellow retinitis (Dx and tx) |
Cytomegalovirus "CMV"
Tx: Ganciclovir or Foscarnet |
|
|
HIV Infections: small deep esophageal ulcers
dx and tx |
Herpes Simplex Virus "HSV": small deep esophageal ulcers (Tx: Prednisone)
|
|
|
HIV Infections:JC virus: PML=Progressive Multifocal Leukoencephalopathy
|
~> brain demyelination (6 mo death)
|
|
|
HIV Infections: Pnemococcus:
disease stain how does it look like |
pneumonia, silver stains, "crushed Ping Pong ball"
|
|
|
HIV Infections: fluffy retina lesions
|
Toxoplasmosis
|
|
|
HIV Infections:
fluffy retina lesions due to Toxoplasmosis Tx |
Tx: Pyramethamine/Folate ~> lifetime Bactrim
|
|
|
HIV Infections: diarrhea
|
Microsporidia
|
|
|
CD4/ Disease/Treatment
< 500 / TB/? |
INH/VitB6
|
|
|
CD4/ Disease/Treatment
<200/ PCP/Tx tx for hypoxia how is it diagnosed? |
Tx: Bactrim (IV) or Pentamidine (inhaled)
Prednisone - add if hypoxic diagnose w / BAL, follow LDH |
|
|
CD4/ Disease/Treatment
< 100 / Candida / Tx |
Fluconazole
|
|
|
CD4/Disease/Treatment:
< 100 / Toxoplasmosis |
Sulfadiazene· + Pyramethimene/Folate
|
|
|
CD4/Disease/Treatment:
<50 / MAl |
Azithromycin
|
|
|
HIV Prophylaxis:
when is it given? |
HIV Post-exposure 4 wks "LIZ"
• Lamivudine (3 TC) • Indinavir • Zidovudine (AZT) |
|
|
do you need to ask the permission to check the patients blood if they were stuck with a needle?
|
you don't need permission to check pt blood if healthcare worker get stuck w/ needle
|
|
|
HIV Tx:
when is it administered? |
• 2 reverse transcriptase inhibitors + 1 protease inhibitor
• HAART: if CD4<350 or symptoms |
|
|
what are the 3 Reverse Transcriptase Inhibitors:
|
Nucleoside analogs:
Non-nucleoside analogs Protease Inhibitors: |
|
|
HIV Markers:
how often to check the status of dz and progression. what are the test? |
Check q3 mo
CD4 count: status of dz Viral load: progression of dz |
|
|
Nucleoside analogs:
SE name all 5 |
painful neuropathy, pancreatitis
• Zidovudine (AZT) • Stavudine (d4T) • Didanosine (ddl) • Zalcitabine (ddC) • Lamivudine (3TC) |
|
|
Zidovudine (AZT): MOA and SE
|
T analog=> low Epo, aplastic anemia, myopathy, nosebleeds
|
|
|
Didanosine (ddl): MOA and SE
|
A analog => pancreatitis <~ only purine analog
|
|
|
Zalcitabine (ddC): SE
|
C analog => painful neuropathy
|
|
|
Stavudine (d4T)
|
T analog
|
|
|
Lamivudine (3TC)
|
C analog
|
|
|
Non-nucleoside analogs:
|
• Nevirapine
• Delavirdine • Efavirenz |
|
|
Efavirenz
|
rash; vivid dreams, may be teratogenic
|
|
|
Nevirapine
|
rash
|
|
|
Delavirdine
|
rash
|
|
|
Protease Inhibitors: SE and what are the drugs
|
inhibit assembly, cause back fat pad
• Indinavir • Nelfinavir • Ritonavir • Saquinavir |
|
|
Indinavir
|
kidney stones, liver toxicity, thrombocytopenia
|
|
|
Saquinavir
|
quick resistance
|
|
|
how do Neutrophils kill: anerobes and aerobes
|
have MPO and NADPH oxidase to kill anything that comes along ...
Anaerobes: no SOD Aerobes: have lots of SOD |
|
|
what are the neutrophillic diseases/
|
Chronic Granulomatous Disease
Myeloperoxidase Deficiency |
|
|
Chronic Granulomatous Disease
mode of inheritance succeptible to what kind of infections Tx test |
(XL): NADPH oxidase deficiency
• Recurrent Staph/ Aspergillus infections • Tx: INF-.γ • Nitroblue Tetrazolium stain negative -> yellow |
|
|
Myeloperoxidase Deficiency:
suceptible to what kind of infections give 3 pathogents |
Catalase (+) infections (Staph/Pseudo/Neisseria)
|
|
|
who are increased risk of Staph/Pseudo Infections?
|
''ABCD"
Agranulocytosis: absolute neutropenia Burn patients Cystic Fibrosis Diabetics |
|
|
what is Extreme Monocytosis? what diseases causes this? and
|
(>15%):
"STELS syndrome" Syphilis- chancre, rash, warts TB - hemoptysis, night sweats EBV- teenager sick for a month Listeria - baby who is sick |
|
|
Dx: Extreme Monocytosis with chancre, rash, warts
|
Syphilis
|
|
|
Dx: Extreme Monocytosis with hemoptysis, night sweats
|
TB
|
|
|
Dx: Extreme Monocytosis with teenager sick for a month
|
EBV
|
|
|
Dx: Extreme Monocytosis with baby who is sick
|
Listeria
|
|
|
PoiKilocytosis
|
different shapes
|
|
|
Anisocytosis
|
different sizes
|
|
|
Monocytes:
what is it what does it use what does it use to kill |
Macrophages in circulation
•change names in different tissues, uses INF • Only has NADPH oxidase to kill |
|
|
Macrophages
function |
• Kills everything that enters tissues
• Processes Ag ⇨ presents to TH during Ab formation |
|
|
Chediak Higashi
cell deficiency pathogenesis presentation |
Macrophage Deficiency:
"lazy lysosome syndrome lysosomes are slow to fuse around bacteria • Oculocutaneous albinism |
|
|
Sulfa Drugs:
give 6 SE in the kidneys, immune system, CNS, hemoglobin mimic what drug |
mimic PABA
• Displace albumin • Anaphylaxis • Interstitial nephritis • Hemolytic anemia • MetHb • Kidney stones |
|
|
tx UTI
|
Sulfamethoxazole/Trimethoprim "Bactrim"
|
|
|
tx burns
|
Sulfadiazine/Pyrimethiamine
|
|
|
eyedrops to prevent newborn Chlamydia
|
Sulfacetamide
|
|
|
tx UC
|
Sulfasalazine
|
|
|
Sulfapyrazone
|
tx UC
|
