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250 Cards in this Set
- Front
- Back
Tounge is smooth, what do you expect to see on peripheral blood smear?
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Megaloblastic anemia with hypersegmented neutrophils (b12 or folate needed for DNA turnover, papillae are smooth)
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What builds up if you have a pyruvate dehydrogenase deficiency? (2)
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Lactate
Alanine |
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What is the difference between the operator sequence and the repressor gene in an inducible operon?
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Operator = Non transcribed regulator
Repressor = Transcribed regulator |
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Dry conjunctiva, Small gray plaques on conjunctiva, corneal necrosis
What vitamin deficiency? |
Vitamin A/retinol
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Recurrence rate of multigenic (non-mendelian inheritance) diseases?
Name 3 examples |
5%
Hirschsprung's, Pyloric stenosis, cleft lip |
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Glycosylated 7-TM receptors are?
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G proteins
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What causes cystinuria?
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Defect in transport for COLA (cystine, ornithin, lysine and arginine)
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Name as many XLR disease as you can
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Hemophilia A and B
G6PD Bruton's agammaglobulinemia Wiskot Aldrich syndrome Fabry's disease Ocular albinism Lesch Nyhan Duchenne's/Becker's muscular dystrophy Hunter's syndrome |
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What are the two galactose metabolism diseases and how do they differ?
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Galactokinase deficiency = just get cataracts
Galactose-1-phosphate uridyl transferase = death in infants (failure to thrive, GI, Hepatosplenomegaly, bleeding, Hypoglycemia, neuronal loss, fatty change) |
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Which polymerase is the only one with 3' to 5' exonuclease activity?
Which polymerase has 5' to 3' exonuclease activity for RNA? |
3' to 5' exonuclease = Bacterial DNA pol 3 (leading strand proofreading)
5' to 3' exonuclease = Bacterial DNA pol 1 (lagging strand) AND Pol 3 because both have to be able to chew away the RNA primers (1 does it way more often) |
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Progressive neurodegeneration
Hepatosplenomegaly Cherry red spot on macula Foam cells What storage disease? Enzyme? accumulation? |
Neimann Pick disease
Sphingomyelinase Sphingomyelin |
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Progressive neurodegeneration
Cherry red spot Lysosomes with onion skin look Storage disease? Enzyme? accumulation? |
Tay Sachs
Hexosaminidase A GM2 Gangliosides |
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Hepatosplenomegaly
Aspectic necrosis of femur Bone crises Crumpled tissue paper Storage disease? Enzyme? accumulation? |
Gaucher's disease
B-glucocerebrosidase Glucocerebrosides |
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Renal failure
Angiokeratomas/Telangiectasias/Rash Peripheral neuropathies in hands and feed What storage disease? Enzyme? accumulation? |
Fabry's disease
a-galactosidase A Ceramide trihexidose |
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Which Storage diseases are XLR? (2)
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Fabry's
Hunter's |
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Where does alcohol metabolsim occur? What enzymes?
What inhibits the second step? |
Alcohol dehydrogenase in the SER/peroxisomes
Aldehyde dehydrogenase in the mitochondria (disulfuram/antabuse inhibits this) |
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Fasting hypoglycemia, increased blood lactate, hepatomegaly
What biochemical disease? |
Von Gierke's
Decreased glucose 6 phosphatase, can't dephosphorylate G6Ps released from glycogen, glucose can't reach blood |
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WAGR syndrome?
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Wilm's tumor
Aniridia (no iris) Genital abnormalities MR |
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RLS of glycogenolysis?
What two things can turn this on? |
Glycogen phosphorylase breakdown of glycogen
Glucagon (liver) Epinephrine (muscle receptors) |
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Glycogen storage disease that is also a lysosomal storage disease?
Defining symptom? Enzyme deficiency? |
Pompei's disease
Lysosomal glucosidase deficiency (acid maltase) Leads to CARDIOMEGALY and early death |
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defect in sickle cell anemia?
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Glutamate for valine on the B-globin chain
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What are shine dalgarno sequences?
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Prokaryotic mRNA seq that binds the 30S ribosomal subunit
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Gene responsible for HNPCC? What other DNA mutation can occur
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Mismatch repair genes (MLH1, MLH2)
Dinucleotide (microsatellite) repeat instability |
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Difference between sporadic and li-fraumeni retinoblastomas?
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Sporadic = later, one eye
Li Fraumeni = early, both eyes |
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Weakness, hypotonia and a hypoketotic hypoglycemia after fasting
What is the problem? What if there is an increase in dicarboxylic acids? What if you see Hypoglycemia hyperketosis after fasting? |
Carnitine deficiency = inability to transport LCFAs into the mitochondria that leads to toxic accumulation of them in the cytosol
Increase in dicarboxylic acids with hypoketosis and hypoglycemia = Acyl CoA dehydrogenase deficiency Hypoglycemia hyperketosis means the FA breakdown is fine but you can't utilize glucose (Glycogen phosphorylase deficiency in McArdles or G6PD) |
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Shuttle for FA synthesis? Breakdown?
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Synthesis = Citrate
Breakdown = Carnitine |
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ApoB48 and ApoB100 loss
What disease? Symptoms? |
Abeta = Lose ApoB48 AND ApoB100 (acanthosis, retinopathy, night blindness, steatorrhea) enterocytes are foamy
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ApoB100 lost
What disease? Symptoms? |
Hypercholesterolemia (Type IIa), increased LDL levels leading to XANTHOMAS and ATHEROSCLEROSIS and corneal arcus but NO pancreatitis (as opposed to hyperchylomicronemia from losing apoC2)
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ApoC2 lost
What disease? Symptoms? |
Hyperchylomicronemia (type 1) = no lipoprotein lipase activation => increased circulating chylomicrons, leads to PANCREATITIS and pain after fatty meal and xanthomas, no risk of atherosclerosis (as opposed to Hypercholesterolemia due to ApoB100 lost)
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What can be made into propinoyl CoA? What is the purpose of this?
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Valine, Isoleucine
Methionine, Threonine Odd chain FAs All are made into propinoyl CoA, which is then made into methylmalonyl CoA (B7 biotin dependent) which is then made into Succinyl CoA (B12 dependent) so that it can be fed into the TCA cycle for energy |
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Which TCA cycle reactions are responsible for creation of the energy equivalents?
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( ) = Citrate to Isocitrate
NADH = Isocitrate to AKG NADH = AKG to Succinyl CoA GTP = Succinyl CoA to Succinate FADH2 = Succinate to Fumurate ( ) = Fumurate to Malate NADH = Malate to OAA ( ) = OAA to Citrate |
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Difficulty in relaxation of hands and feet, disorganized sarcoplasmic masses
Disease? |
Myotonic dystrophy
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Color blindness inheritance?
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XLR
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Defect in copper transporting P-type ATPases leads to what disease? Why are they hyperpigmented?
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Ehlers Danlos type IX, Lysyl oxidase requires copper
Tyrosinase also requires copper (no melanin from L-DOPA) |
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Black urine on exposure to light, bad arthritis. What builds up?
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Alkaptonuria
Homogentisic oxidase mutation Homogentisic acid and Tyrosine builds up (can't make it into fumurate) |
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What amino acid can be made directly into Acetyl CoA? Propinoyl CoA?
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Leucine into Acetyl CoA
Val, Ile, Met, Threonine into propinoyl CoA into methylmalonyl CoA into succinyl CoA |
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16S rRNA and 23S rRNA are located where? Function?
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16S rRNA is on the 30S bacterial ribosome, responsible for binding shine dalgarno sequences upstream or AUG start codons
23S rRNA is located on bacterial 50S ribosomal subunits and have PEPTIDYL TRANSFERASE activity to transfer AAs to growing peptide (23S rRNA targetd by linezolid, Peptidyl transferase targetd by chloramphenicol) |
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What is a kozac sequence? Disease association?
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3 bases upstream of AUG mRNA start codons, mutation can lead to Thalassemia minor (with a hypochromic microcytosis)
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Triad in plummer vinson syndrome?
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Dysphagia (esophageal web)
Koilonychias Glossitis Iron deficiency anemia (microcytic hypochromic anemia) |
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Heterochromatin vs Euchromatin
Modification that causes this? |
Methylatin/Alkylation => Heterochromatin => SILENT
Acetylation => Euchromatin => ACTIVE |
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Which enzyme activates the pancreatic proenzymes? How is THAT enzyme activated?
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Enteropeptidase located in the duodenum activates protrypsin into trypsin which then activates all the rest of the pancreatic enzymes for protein digestion (carboxypeptidase, elastase and chymotrypsin)
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Ureas nitrogens are from what two sources? What about its carbon?
What transports ammonia from the periphery to the kidney? |
Ammonia and aspartate = Ns
CO2 = C GLUTAMINE is the shuttle for ammonia from the periphery to the kidney where it is excreted |
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RLS for urea cycle? What activates it?
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Carbamoyl phosphate synthetase 1 (makes carbamoyl phosphate out of ammonia and CO2)
N-acetylglutamate activates it |
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What processes of collagen synthesis occur intracellularly? Extracellularly?
Which part is scurvy targeting? Ehlers danlos? OI? |
IC = Hydroxylation (vit C, scurvy), glycosylation, assembly of triple helix (OI, type 1 collagen)
EC = N/C terminal propeptide cleavage (peptidase), Cross linkage (Lysyl oxidase, copper req) => deficiency in any of these two leads to Ehlers danlos (type 3 collagen) |
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Which sugar is rapidly metabolized and why?
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FRUCTOSE, it is phosphorylated in the liver and enters glycolysis AFTER the regulatory PFK sttep
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Where is glycerol kinase located and what is its purpose?
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Only in the liver, makes glycerol from TG breakdown into G3P which can be shunted into glycolysis
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HbS vs regular Hb, what will be seen on protein electrophoresis?
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moves LESS, loss of glutamic acid leads to less negative charge, doesn't move as much toward anode (+)
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What causes methemoglobinemia? What cures it?
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Nitrates (ferrous to ferric)
Methylene Blue |
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Enzyme responsible for making sugars into osmotically active molecules
Name the four cells that this is a problem for Name two cells that have this enzyme but can address this problem |
Aldose reductase (glucose into sorbitol, galactose into galacticol, fructose into frucitol...)
Schwann cells, Lens, Retina and kidneys (causes swelling in these cells) Liver and seminal vesicles have SORBITOL DEHYDROGENASE to elimate it |
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Lead has a strong affinity for what kind of chemical groups? Big two enzymes it inhibits?
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Sulfhydryl groups
Ferrocheletase and ALA dehydratase |
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Triad of Wernicke's encephalopathy? What makes it into Korsakoffs?
What is the pathophysiology of WHY this occurs? Diagnostic test? |
Ataxia, Ophthalmoplegia, confusion
Confabulation, memory loss and personality change= Korsakoff's B1 deficiency leads to inability to utilize glucose (dehydrogenase enzymes) in cerebral cells, increased levels of erythrocyte TRANSKETOLASE activity/levels is diagnostic |
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Deletion/Addition of base pairs that is NOT a multiple of 3 indicates what?
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FRAMEshift mutation must have occured
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Lung opacities in the superior region of the lower lobes = suscpicion for what? (name some other factors)
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Aspiration pneumonia or abscess
Elderly, alcoholic, decreased muscle tone |
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Splenomegaly has the same pathophys as what heart condtion?
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hypertensive hypertrophy
Both lead to hypertrophy of cells (NOT hyperplasia like in benign prostatic hyerplasia) |
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Which portions of mRNA are NOT transcribed from DNA?
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3' Poly A tail
5' 7-MG cap |
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Describe the process of base excision repair
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1) Glycosylases cleave altered base
2) Endonuclease cleaves 5' end 3) Lyase cleaves 3' end 4) DNA pol and Ligase clean up |
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Deletion/Addition of base pairs that is NOT a multiple of 3 indicates what?
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FRAMEshift mutation must have occured
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Lung opacities in the superior region of the lower lobes = suscpicion for what? (name some other factors)
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Aspiration pneumonia or abscess
Elderly, alcoholic, decreased muscle tone |
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Splenomegaly has the same pathophys as what heart condtion?
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hypertensive hypertrophy
Both lead to hypertrophy of cells (NOT hyperplasia like in benign prostatic hyerplasia) |
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Which portions of mRNA are NOT transcribed from DNA?
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3' Poly A tail
5' 7-MG cap |
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Describe the process of base excision repair
What could cause defects that this process would be required for? |
1) Glycosylases cleave altered base
2) Endonuclease cleaves 5' end 3) Lyase cleaves 3' end 4) DNA pol and Ligase clean up SINGLE base defects (like NITRATES that cause deamination of bases) |
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CF mutation?
Most abundant AA in collagen? |
Phe deletion
Glycine |
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An apparently healthy person excreting fructose or galactose in urine. What is the problem? What if they were real sick
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healthy = Fructokinase or Galactokinase
not healthy = Aldolase B or Galactose uridyl transferase) |
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What is the overarching purpose of the HMP shunt?
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provide source of NADPH for anabolic reductive reactions like glutathione reductase, FA and cholesterol synthesis
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4 irreversible enzymes of gluconeogenesis?
Name cofactors/energy each enzyme require. Which ones are in the mito and which ones are into cytosol? |
Pyruvate carboxylase (pyruvate into OAA), MITO, requires Biotin, ATP and is actiavted by Acetyl CoA
PEP carboxykinase (cytosol), OAA back to PEP, requires GTP Fructose 1,6,bisphosphatase Glucose 6 phosphatase |
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Allosteric activator of gluconeogenesis?
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Acetyl CoA on Pyruvate carboxylase (Mitochondria, Biotin and ATP)
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Tryptophan deficiency could lead to what two other deficiencies?
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Niacin (requires B6, leads to pellegra)
Seratonin/Melatonin (requires BH4) |
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Name 3 causes of pellegra
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Niacin Deficiency
B6 deficiency (isoniazid for ex., required to make niacin from tryptophan) Hartnup's disease (decreased tryptophan absorption) |
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Vomiting, lethargy and failure to thrive after breast feeding
What disease? Discern between the two types of this disease |
Galactosemia
Classic = GALT deficiency, will have cataracts, juandice, hepatosplenomegaly and MR Galactokinase deficiecny = will only have cataracts with maybe an initial failure to track objects/develop a social smile, galactose appears in the blood/urine |
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Which lysosomal storage disease presents with skin lesions?
Name other symptoms |
Fabry's disease (angiokeratomas + peripheral neuropathies, renal fail, CV disease)
A-galactosidase Build up of ceramide trihexoside |
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When would you want to induce methemoglobinemia and how do you do this?
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Cyanide poisoning, induce metHb with nitrates to cause ferrous into ferric, this binds CN- and prevents it from binding cytochrome oxidase and screwing with ETC (also use hydroxycobalamin and thiosulfate for antidote)
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Name inhibitors of ETC and uncoupling agents
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1 = Amobarbitol, Rotenone
2 = Antimyin 4 (cytochome oxidase) = CN and CO ATPase = Oligomycin Uncouplers = 2,4 DNP, Aspirin, thermogenein in brown fat |
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Antidotes
1) APAP 2) Salicylates 3) Amphetamines 4) AChesterase inhibitors, organophosphates 5) Antimuscarinics, antiACh, Jimson weed |
1) N-acetylcysteine
2) NaHCO3 (sodium bicarbonate, alkalinize urine) 3) NH4Cl (ammonium chloride, acidify urine) 4) Atropine and Pralidoxime 5) Physostigmine |
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Antidotes
1) BBs 2) Digitalis 3) Iron 4) Lead 5) Copper |
1) Glucagon
2) Stop, normalize K+, Lidocaine, Anti dig Fab, Mg2+ 3) Deferoxamine 4) Dimercaperol, EDTA 5) Penicillamine |
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Antidotes
1) Cyanide (3) 2) Methemoglobin (2) 3) CO 4) Methanol, Ethylene glycol 5) Opioids |
1) Nitrates, Hydroxycobalamin, thiosulfate
2) Methylene Blue, Vitamin C 3) 100% O2 4) Ethanol (dialysis, fomepizole = competitive inhibitor of alcohol dehydrogenase) 5) Naloxone/Naltrexone |
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Antidotes
1) BZDs 2) TCAs 3) Warfarin 4) Heparin 5) tPA, streptokinase 6) Theophylline |
1) Flumazenil
2) NaHCO3 (serum alkalinization, Na for arrythmias?) 3) Fresh frozen plasma, vit K 4) Protamine sulfate 5) Aminocaproic acid 6) BBs |
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MCC of homocystinuria? Symptoms? (2)
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Cystathione synthetase deficeincy (B6, homocysteine to cystathione to cysteine)
Leads to thromboembolic disease and marfan's habitus |
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Orotic acid uria leads to what kind of symptoms?
How do you treat? Name 3 enzymes that can cause this and the way you can tell the difference between them |
Orotate phosphoribosyl transferase and OMP decarboxylase (both on same polypeptide) ==> required for creation of pyrimidines ==> causes megaloblastic anemia with neurological abnormalities and growth retardation
OTC1 deficiency, can't take ornithine and make it into citrulline, ornithine is shunted to orotic acid leading to orotic aciduria. These patients will have HYPERAMMONEMIA and have hyperammonemic encephalopathy. Treat the first one with URIDINE (inhibits carbamoyl phosphate synthetase II AND replaces deficient UMP) |
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4 types of reactions that B6 is used for?
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Transamination
Deamination Decarboxylation (carboxylation is B7) Condensation |
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How does glucose cause insulin release? What drug works the same way?
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Glucose enters GLUT2 channels on the B-cells of the pancreas, this increases ATP/ADP ratio leading to closure of KATP channels, this depolarizes the cell leading to an increase in IC clacium and a release of insulin
Sulfonylureas (Glipizide, glyburide...) act by binding to KATP channels and causing them to close (increasing insulin release) |
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Increase in what enzyme activity would cause increased synthesis of purines AND pyrimidines? Disease exacerbation?
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PRPP synthetase
Exacerbates Gout (hyperuricemia) |
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Fructose absorbed in proximal small bowel by what channel?
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GLUT-5
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Green color in bruises is caused by what?
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Heme oxygenase breaking down heme into BILIVERDIN (green)
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What do Homeobox DNA seq code for?
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DNA binding transcription factors that are usually involved in MORPHOGENESIS
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Which of the adrenergic receptors are Gs? Gi? Gq?
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Gq = a1 = IP3/DAG, increase IC calcium, increase PKC
Gs = B1, B2 = increase AC, increase cAMP, increase PKA Gq = a2 = decrease AC, decrease cAMP, decrease PKA |
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Breast milk lacks which 2 vitamins that must be supplied to infants?
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Vitamin D and K (sunlight and IM injection at birth)
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What is the P50 of the oxygen saturation curve?
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partial pressure of O2 where Hb is 50% saturated.
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In the lac operon:
What are the effects of glucose? What are the effects of lactose? |
Glucose = decreases AC, cAMP and causes poor binding of CAP to DNA binding domain, this leads to DECREASED expression of the structural genes
lactose = Normally binds and sequestors the repressor protein what normally binds to the operator, thus lactose INCREASES operon gene production |
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If gibbs free energy is positive? Negative?
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Positive = substrate favored
Negative = product favored |
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Name as many conditions that would cause sickled cells to sickle more
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Anything that INCREASES O2 unloading
Acidic state (increased H+, decreasd pH) Increased 2,3 BPG Low blood volume Increased temperature (ALL RIGHT SHIFTS) |
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What is the purpose of lactate dehydrogenase?
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in Anaerobic conditions where you can't oxidatively decarboxylate pyruvate into acetyl CoA, thus you create lactate to RESTORE NAD+
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How do RBCs increase O2 release at tissues? (with an enzyme)
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Phosphoglycerate mutase, changes 1,3 BPG into 2,3 BPG, releases that which causes right shift and O2 release
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Painful abdomen, urine is pink, polyneuropathies and mental changes.
What disease is this? What can be found in the blood? Treatment? |
Acute intermitten porphyria
Caused by alcohol, barbituates, hypoxia that increase ALA synthase leading to a build up of ALA and Porphobilinogen Porphobilinogen deaminase is deficient Treat with glucose and heme that inhibit ALA synthase |
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Patient comes in with blistering cutaneous photosensitivity and tea colored urine
What disease? found in blood? |
Porphyria cutanea tarda
Deficiency in Uroporphyrinogen decarboxylase Uroporphyrin builds up in the blood and urine |
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Neutral AAs in the urine
vs Generalized AAs in the urine What diseases? |
Neutral = HARTNUPs disease (no tryptophan, PELLEGRA)
Generalized = FANCONI'S SYNDROME |
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Encephalopathy (Chorea, spastic paresis) + high levels or ARGININE
What is the issue? |
Arginase deficiency, required for urea formation
get rid of arginine from diet |
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MAP kinase is the end effect of what signaling pathway?
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Tyrosine kinase => Ras => Raf => Map Kinase
Insulin, PDGF, IGF-1, FGF |
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What step of glycolysis needs NAD+?
what are the two ways you can restore NAD+ after it is reduced? |
G3P to 1,3 BPG
use lactate dehydrogenase or pyruvate dehydrogenase to go into TCA to restore NAD+ |
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Skeletal muscle contraction is coupled with what process? (think glucose) Explain the process
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Glycogen degredation, calcium activates muscle glucogen phosphorylase to release glucose from glycogen (Calcium mediated myophosphorylase activation), this does NOT contribute to blood levels of glucose
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Where are DNA promotor regions usually located?
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25-70 basepairs upstream (TATA or CAAT)
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Hormones that act on surface receptors are synthesized where in the cell? What if they act on nuclear receptors?
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Surface receptors = peptides = RER production
Nuclear receptors = steroid hormones = SER production |
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Main transporter of ammonia from liver to kidneys or periphery to kidneys?
Describe this process, What is the main amino acid that is used in the LIVER |
Glutamate! Glutaminase breaks it down for ammonia excretion in the kidneys
Amino acids are transaminated with AKG into alpha ketoacids and glutamate. Glutamate then delivers the ammonia to the kidneys, ALANINE is the main amino acid used in the liver to make glutamate and thus shunt the ammonia to the kidney or the urea cycle |
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Brain, RBCs, Kidneys, Skeletal muscle, Liver and Cardiac muscle
Which ones can utilize ketones? Which cannot? |
Brain, Kidneys, Skeletal and Cardiac muscle can use ketones
RBCs and Liver cannot |
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atrophic glossitis, shuffling gait, pain/temp/vibration sense gone
What disease? |
B12 deficiency
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Why do you get photosensitivity in porphyria cutanea tarda?
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Build up of porphoryin/uroporphyrins leads to superoxide mediated free radical formation when exposed to the sun
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Name the cycles that occur in mito
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TCA, Parts of Heme synthesis, parts of Urea cycle, FA oxidation/Ketogenesis
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What causes wrinkles?
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decreased collagen/elastin PRODUCTION
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Vitamin with the longest storage in the liver?
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B12
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Hydroxylation of collagen occurs where?
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RER
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Difference between elastin and collagen structure?
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Elastin has glycine, alanine, valine and proline/lysine but they are NOT hydroxylated
Tropoelastin fiber (NOT a triple helix like collagen) is made, secreted and interacts with FIBRILLIN, lysine sidechains from a covalend DESMOSINE crosslink (stretchy properties |
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What are the ketogenic amino acids? When could you give them to someone as treatment?
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Leucine, Lysine
give em to someone suffering from LACTIC ACIDOSIS to shunt products away from lactate |
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Build up of limit dextrins
What disease? Enzyme deficiency? |
Cori's disease
Debranching enzyme deficiency Can't transfer a(1,6) branches onto ends of long strand, builds up |
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how soon does glycogen run out? What takes over after that
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hours, gluconeogenesis takes over after that
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ApoA-1 is responsible for what? Deficiency leads to what?
ApoE3/E4 are responsible for what? |
Apo A-1 = LCAT activation (cholesterol esterification in HDL, deficiency leads to low HDLs and increased free cholesterol)
Apo E3/E4 = VLDL and chylomicron remnant uptake by liver (deficiency leads to elevated serum TG and cholesterol) |
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What enzyme deficiency would also present like G6PD? Why?
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Glutathione reductase deficiency, each leads to inability to restore glutathione which protects RBCs from oxidative damage
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Compare hemoglobin to myoglobin curves
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Remember the hemoglobin is four myoglobins
Myoglobin has a parabolic curve with a Low P50 Hemoglobin has a sigmoidal curve with a higher P50 Remember that if hemoglobin was split up they would all have parabolic myoglobin curves, this is due to the cooperative binding and dissociating of hemoglobin |
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Compare and contrast glucagon/Epinephrine and insulin's effects on glycogen metabolism
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Glucagon/Epi = activate AC, cAMP and PKA, causes phosphoarylation of glycogen phosphorylase, activates it, leads to glycogenolysis and release of glucose (This is also activated by CALCIUM which activates a kinase that is coordinated with calcium influx from muscle contraction)
Insulin = tyrosine kinase dimerization activates a protein PHOSPHATASE that dephosphorylates glycogen phosphorylase, this decreased glycogen breakdown and decreased blood glucose Glucagon = Liver Epi = Liver and muscle |
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Foamy histeocytes + hepatosplenomegaly
Crumpled paper + hepatosplenomegaly What disease? |
Neimann Pick's disease = Foamy
Gaucher's disease = Crumpled |
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upregulation of serine kinase instead of tyrosine kinase can lead to what?
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Insulin resistance
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What kinds of FAs cannot be broken down in the mitochondria? Where do they have to go instead?
Deficiency in this process? |
Very long chain FAs or Branched fatty acids (Phytanic acid from plants)
Deficiency = ZELLWEGER syndrome (infants can't make myelin in CNS leading to hypotonia, seizures, hepatomegaly, MR and early death) THey go to PEROXISOMES instead to get spcial oxidation |
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What disease should you avoid chlorophyll in your diet? Why?
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Refsum disease
Inability for peroxisomal alpha oxidation of branched chain FAs (build up of phytanic acid and neurological symptoms) |
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HbS vs HbC
think about electrophoresis |
HbC is less severe form of sickle cell
HbS = valine where glutamate should be (neutral for negative) HbC = Lysine for glutamate (positive for negative) HbC will travel LESS distance than HbS due to repelling from positive anode |
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Compare glucokinase to hexokinase and where they are located
Talk about Km, Affinity, Capacity, VMax, insulin induction and feedback inhibition |
Glucokinase = Liver and B-cells of pancreas
HIGH Km, low affinity High capacity, high vMAX Induced by insulin NOT feedback inhibited Hexokinase = ubiquitous Low Km, High affinity Low capacity, Low Vmax Uninduced by insulin Feedback inhibited by GP6 |
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Someone eats a lot of eggs and gets lactic acidosis. What happened?
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Biotin binds to Avidin in egg whites, without biotin you can't carboxylate (pyruvate carboxylase needed to deplete pyruvate, excess shunted to lactate)
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Septate fungal hyphae at acute angles?
Wide angled non septate hyphae? |
Aspergillus
Mucor mycosis or Rhizopus (Diabetics!) |
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Pseudohyphae and oval budding yeast on LM?
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Candida (germ tubes, pseudohyphae)
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Why is IgM better at activiting the classical complement pathway?
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C1 must bind the Fc portion (near the hinge) of TWO different antibodies which is why IgM is so much better than IgG
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Diabetic ketoacidosis, Facial Pain, headache with a black necrotic eschar in the nasal cavity.
What is this? WHY does it occur in these patients? |
Mucormycosis (mucor, rhisopus or absidia), Rhizopus has high affinity for ketones and high blood glucose (has ketone reductase)
Treat with amphotericin B |
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What organisms are able to transform DNA from the environment?
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SHiN capsular organisms
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What hypersensitivity is Post strep glomerulonephritis? What two things will you find deposited?
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Type 3
C3 and immunocomplexes, subepithelial deposits |
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Which antibody does NOT fix complement and is a weak opsonin
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IgA
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Describe hyperacute, acute and chronic rejection and their appearance microscopically
|
Hyperacute = preformed antibodies, immediate organ dysfunction
Acute = B and T cell infiltrates, present after 1-2 weeks Chronic = scant inflammatory cells, fibrosis, months to years after |
|
Measles four MC symptoms? What virus causes and it and from what family?
|
Measles = Rubeoloa = Paramyxovirus
CCCK Cough, Coryza, Conjunctivitis Koplik's spots (Small blue/white spots on buccal mucosa) maculopapular rash on face and moves down (differential with rubella which has posterior cervical lymphadenopathy) |
|
Th1>Th2, which leprosy? Symptoms?
|
Tuberculoid, Th1 holds it in check, causes hypopigmentation, and decreased sensation in patches on the skin
|
|
Th2>Th1, which leprosy? SYmptoms?
|
Lepromatous, leonine facies, M. leprae gathers at temps lower than body (skin, superficial nerves, eyes and testes)
|
|
Staph gets a beta lactamase, what abx do you use?
Staph changes its PBPs, what abx do you use? |
Methicillin, Oxacillin, Nafcillin
Vancomycin |
|
What Abx
RNA pol mutation resistance Efflux pump resistance (2) Altered DNA gyrase resistance |
Rifampin
Tetracycline, Sulfa Fluoroquinolones |
|
What bacteria is not a good vaccine canditiate due to antigenic variation of their mucosal attachment pilli
|
Neisseria gonorrhea
|
|
Which Hepatitis viruses are naked and what does this imply?
|
A and E, hit your bowels because they are not destroyed in the gut
|
|
Black eschar on skin with central necoris
What organism? Where is it found? |
Anthrax, animal products or biological warfare
|
|
High IgE levels and eosinophilia in patients with asthma or CF
What causes this? Repeated exacerbations of this leads to what? |
Aspergillus! = Allergic bronchopulmonary aspergillosis
Repeated = transient pulmonary infiltrates and proximal bronchiectasis |
|
Which cells have MHC class 1? Class 2? How are they produced and transported to cell surface?
|
MHC class 1 = located on ALL nucleated cells, single heavy chain with a B2 microglobulin that assists in transport to cell surface
MHC Class2 = on APCs (dendritic cells, macrophages, B cells), formed by Alpha and beta subunits |
|
Thayer martin media?
Chocolate agar? How do they work? |
Thayer martin = VCN (vanco gets rid of gram +, Colistin or Polymixin gets rid of gram - and Nystatin gets rid of fungi), Used for NEISSERIA GONORRHEA
Chocolate = has factor V (NAD+) and Factor X (Hematin), used for HAEMOPHILUS INFLUENZAE |
|
Which of these agar are differential? Enrichment? Selective?
MacConkey VCN thayer martin EMB Chocolate |
Chocolate = Enrichment
VCN = Selective MacConkey = Differential and selective (Bile salts selects for Gram - bacteria, differentiates between lactose fermenters/pink from non lactose fermenters) EMB = Differential and selective (eosin methylene blue) |
|
Which pneumoconioses increases risk for both TB and bronchogenic CA?
HOW does it increase TB risk? |
Silicosis
decreases macrophage arm of cell mediated defence needed for TB |
|
Th1 and Th2 differ how?
|
Th1 = CELL mediated
Th2 = Humoral immunity |
|
Gram - curved rod
MCC of what? |
Campylobacter jejuni
MCC of gastroenteritis in industrialized countries |
|
Custard and Mayo can have toxins from what bacteria?
Fomites in daycare centers? Steamed fried rice? Contaminated shellfish? |
Staph = Mayo/custard
Daycare fomites = SHIGELLA Steamed fried rice = Bacillus cereus Shellfish = Vibrio parahaemolyticus |
|
MSM transmission
Which hepatitis? |
Hep B
|
|
East of the mississippi, immunocompetent, granulomas in the lung, broad based buds with double refractive walls
What bug? |
Blastomycoses
|
|
CD14 is a marker for? CD20? CD7?
|
CD14 = monocyte macrophage
CD20 and 19 = B-cell CD7 = T-cell |
|
ssDNA virus, What are you thinking?
What disease does it cause? Major symptoms? |
parvovirus B19
Erythema infectiosum (fifth's disease) Slapped cheeks! Aplastic crisis (tropism for RBCs, marrow), hydrops fetalis... etc. |
|
Which 3 bacteria have LOW infectious doses
|
Shigella, EHEC and Campylobacter
|
|
How many organisms of entamoeba histolytica or Giardia does it take for infection?
|
1
|
|
Meningitis in a HIV (+) patient, CD4 < 50
|
Cryptococcus
India ink of CSF, Antigen as well |
|
Fever + vesiculoulcerative lesions of oral mucous membranes + local lymphadenopahy
|
PRIMARY HSV1 (first infection is the worst)
|
|
How can you inactivate naked viruses? (how do you kill them?)
|
Chlorination
Bleach UV Boiling to 85 degrees C (Acid, drying and ethers do NOT damage them) |
|
PIP and MCP joints painful and stiff, pain gets better with use
What disease? What markers? What hypersensitivity? |
RA
RF (IgM against IgG = forms immunocomplexes and deposits in joints, TYPE 3) |
|
Anti Mitochondial antibody
|
Primary biliary cirrhosis
|
|
LPS is found in what kind of bacteria? What portion of it is toxic? What does it cause?
|
LPS = gram - bacteria
Lipid A = toxic, causes septic shock and DIC by causing release of TNF-a, IL-1 and IFN-y, C3a, C5a LPS is NOT secreted |
|
K1 capsular antigens, bug?
Heat stabile/labile exotoxins, bug? |
E.coli, neonatal meningitis
ETEC, travelers diarrhea |
|
Causes of aspectic meningitis?
2 MC causes of bacterial meningitis in adults? MC cause of meningitis in HIV? |
Enteroviruses (coxsackie, echovirus, polio or other enteroviruses)
Adults = Strep pneumoniae, then Neisseria meningitidis Cryptococcus MC in AIDS (look india ink or antigen in CSF) |
|
Primary HIV receptor? What are the two other ones? mutation to which one leads to resistance
|
Primary = CD4
Macrophage = CCR5 T-cell = CXCR4 Mutation to CCR5 = resistance |
|
Where are B-cells made? Where do they isotype switch?
|
Made and mature in the bone marrow, then go to lymph nodes for exposure
Isotype switch and activated in the GERMINAL CENTERS |
|
Discern between central and peripheral tolerance
|
Central = in the thymus, negative selection, if a maturing T-cell reacts to a self MHC antigen, it is destroyed
Peripheral = develops by CLONAL ANERGY, if a T-cell reacts to self antigens it is inactivated and becomes ANERGIC |
|
2 stains used for cryptococcus neoformans
|
India Ink
Mucicarmine (appears red) |
|
How do you form vaccines for the SHiN organisms?
|
Conguate a protein (diphtheria or tetanus toxoid) to the capsular carbohydrate to allow for better T-cell uptake and response.
Carbohydrate capsules are much worse at being taken up by APCs |
|
PRP (polyribose ribotol phosphate) capsule
What bacteria? |
H. flu
|
|
Ovoid bodies in macrophages, hilar lymphadenopathy
What bug? What does it present like? |
Histo!
Histo, Blasto and Coccidio present like TB |
|
MC pathogen causing cystitis and pyelonephritis?
2nd MC in sexually active women? |
MC = E. coli
2nd MC in women = Staph saprophyticus |
|
Nitroblue tetrazolium
What is this used for? |
Chronic granulomatous disease
No NADPH oxidase leads to no blue color formation in neutrophils (inability to make reactice oxygen species, recurrent pyogenic infections) |
|
3 MC organisms for OM? Recurrent OM indicates what kind of deficiency?
|
Strep pneumo, H. flu, Moraxella
Recurrent = Humoral deficiency |
|
C5-C9 deficiency = what bug infection?
|
Neisseria
|
|
3 functions for IL-4? IL-5?
IL10 IL12 functions? |
IL4 = B-cell growth, IgE switch, Th2 promotion
IL5 = B-cell differentiation, IgA switch, Eosinophil for parasitic infections IL10 = Th2 (humoral) IL12 = Th1 (cell mediated) |
|
Which two bugs have A-B toxins that ADP ribosylate EF-2 to decrease protein synthesis
|
Diphtheriae
Pseudomonas (also the function of Rb tumor supressor) |
|
Which two bugs inactivate human 60S ribosomal subunit?
|
EHEC
Shigella |
|
3 MC cause of pneumonia?
What paves the way for pneumonia? |
Strep pneumonia, Staph aurues, H. flu
Viral infection (influenza A) |
|
Pneumonia in alcoholics/IVDAs
Nosocomial UTIs/pneumoina What bug? |
Klebsiella
|
|
MCC of reiter's syndrome? What is it also called? What is the triad?
|
Usually post Nongonococcalurethritis (chlamydia or ureaplasma)
Reiter's syndrome = Reactive arthritis 1) Conjunctivitis/Uveitis 2) Urethritis 3) Arthritis (asymmetric) |
|
Repeated 2nd/3rd trimester miscarriages, Recurrent DVTs and a false positive syphillis test
Whats wrong? What lab test is weird... |
SLE ==> Lupus anticoagulant ==> Antiphospholipid syndrome
Hypercoagulable with a paradoxical elongation of PTT time |
|
5 organisms with lysogenic phage transducing toxins?
|
ABCDE
shigA toxin Botulinum toxin Clostridium toxin Diphtheria toxin Erythrogenic toxin of GAS |
|
Fimbrae, UTIs and pyelonephritis
What bug? |
E. Coli
Use fibrae to adhere to uroepthelial cells, P-fimbrae can lead to pyelonephritis K1 capsular antigen of E. coli causes meningitis |
|
Metronidazole used for which bugs?
Mebendazole Albendazole Thiabendazole Praziquantel |
Metro = GET (Giardia, Entaemeba histolytica, trichimonas vaginalis, Gardnerlla vaginitis, anaerobic bacteria)
Mebendazole = Nematodes aka roundworms (non invasive, enterobius, necator/anclyostoma, ascaris, trichiruria) Albendazole = (echninococcus and taenia solium cystercircossis, also used for invasive nematodes like trichinella, anisikiasis, cutaneous and visceral larva migrans) THiabendazole = Strongyloides nematode (roundworm) Praziquantel used for taenia saginata, diphyllobothorium (cestode tapeworms), all flat worms (Schistosoma, paragoniums and chlonorchis sinensis) |
|
Killed vaccines?
Live vaccines? Toxoid vaccines? Conjugate? |
Killed = RIP Always (Rabies, Influenza, Salk Polio, Hep A) ==> only HUMORAL immunity
Live = Small yellow chicken Sabin Polio, MMR Toxoid = dTAP (Diphtheria, pertussis, Tetanus) Conjugate = HBV, HPV |
|
Organism for the following agar:
Cysteine tullurite Mackonckees Thayer martin Blood agar Bordet Gengou Charcoal yeast |
Cysteine tullurite = Loeffler's media = C. diphtheriae
Mackonckees = Enteric bacteria Thayer martin = VCN = Neisseria gonorrhea Blood agar = Eneterococci culture (differentiates enterococci from group D strep) Bordet Gengou = Bordetella pertussis Charcoal yeast = Leigonella |
|
bacteria that causes hemolytic anemia? Pathophys?
|
Mycoplasma pneumoniae (cold agglutinins, IgM, causes intravascular/extravascular hemolysis, mimicry?)
|
|
rose spots on the abdomen + fever + diarrhea
Organism? virulence? sites of infection? |
Salmonella typhi (typhoid fever)
Infects through M-cells in the peyer's patches, macrophages then carry organism to liver spleen and bone marrow (can sit in gallbladder for seeing of the GI tract) |
|
purulent cervical discharge
organisms? treatment? if disseminates to peritoneum? |
PID
N. gonorrhea, C. trachomatis 3rd gen ceph + Azithro/Doxy Fitz Hugh curtis if disseminates to peritoneum or liver capsule |
|
Firm dome shaped umbilicated papules on skin
Organism? |
Molluscum contagiosum
Pox virus |
|
Posterior lymphadenopathy + rash on face moving downwards
Organism? What if it was congenital? |
Rubella (german measles)
Congenital = PDA, deafness and cataracts |
|
Three organisms that cause papular rash from the palms/hands spreading toward the trunk
|
Coxsackie A
Secondary syphilis Ricketssia |
|
CD21, what is it used for?
P antigen? |
B-cell thing that EBV attaches to for infectious mononucleosis
P-antigen = thing that B19 parvovirus attaches to on RBCs |
|
Tumbling motility
What bug? What does this bug require for infection? |
Listeria
Requires cell mediated immunity to enter cells that phagocytose it |
|
What two disease can cause a positive Nikolosy's sign
|
Pemphigus vulgaris
Scalded Skin syndrome (staph aureus exfoliatin toxin) |
|
Which organism has protein A? IgA protease?
|
Protein A = Staph, binds Fc portion of igG at complement binding site (hinge region) and doesn't let complement activate
IgA protease = SHiN orgnaisms (allows for penetration of mucosa, neisseria needs this to cause meningitis, gets across and then goes through the choroid plexus) |
|
Oral thrush, interstitial pneumonia and severe lymphopenia in a newborn
What happened? how do you prevent? |
HIV vertical transmission, give mom zidovudine (RT inhibitor to prevent transmission)
|
|
What drug blocks fusion of HIV (penetration)?
|
Enfuviritide, blocks gp41
|
|
IFN alpha is indicated for what 5 disease?
|
Hep B
Hep C Hairy cell leukemia Condyloma acuminatum (genital wart) Kaposi's sarcoma |
|
what organism still causes OM even though we vaccinate? Why?
|
H. flu B, we vaccinate to prevent meningitis, epiglottits and pneumoina
only against type B, there are other strains that still cause OM |
|
Eczema, thrombocytopenia (purpura, petichiae), recurrent infections
What disease? Defining features? |
Wiskott Aldrich disease, X linked
Combined B and T cell due to progressive B and T cell deletion (leads to infections) IgM is down but IgE and IgA may be up |
|
Albinism + peripheral neuropathies + immunodeficiency
What disease? Pathophys? |
Chediak higashi
MT dysfunction leading to inability to form the phagolysosome |
|
Recurrent sinopulmonary and GI infections
What disease? Blood transfusion? |
IgA deficiency
Can lead to hypersensitivity reaction to IgA in blood transfusions |
|
Recurrent cutaneous infections without pus formation, umbilical stump does not fall off
What disease? Pathophys? |
Leukocyte adhesion deficiency (CD18 integrin mutation)
Poor wound healing |
|
Anti Jo1, increased serum CK
What disease? pathophy? main symptom? |
Polyomyositis/Dermatomyositis
Grottons papules (MCP, PIP, DIP) CD8 T-cells destroy muscle Proximal muscle weakness |
|
Bilateral stiffness of shoulder/girdles, fever, weight loss and increased ESR
What disease? |
temporal arteritis with Polymyalgia rheumatica
|
|
Recurrent fever, chills and sweats, episodic hematuria
what disease? Treatment? (2) |
Malaria
Plasmodium Chloroquine (blood stream), Primaquine (get rid of liver vivax/ovale, prevente recurrence) |
|
Hypopigmented/hyperpigmented skin patches/papules that are NOT anesthesized
Who did this? Characteristic microscopic view? What if they were anesthesized? |
Tinea versicolor caused by Malessezia furfur (cutaneous mycoses, spaghetti and meatbulls appearance on KOH, hyphae look like cigar butts, treat with antifungals or selenium containing shampoo)
Anesthesized = Tuberculoid leprosy (Th1>Th2) |
|
toxin that screws up actindepolymerization
What bug |
C diff (cytotoxin B, also has toxin A = enterotoxin)
|
|
Serpentine growth of thick ropelike cords
What is this, what bug? What does it mean? |
TB, CORD FACTOR (virulence factor of TB, inactivates neutrophils and damages mitochondria and releases TNF)
|
|
Migratory polyarthritis
What disease? |
Rheumatic ferver (JONES)
|
|
Child, Lethargy, Oliguria, Bloody diarrhea, elevated urea and creatinine, shitocytes
What disease |
HUS, undercooked beef, E. coli O157:H7
|
|
Custard mayo, what bug?
Fried rice, what bug? Raw oysters? (2) Raw eggs? Canned beans? Contaminated food? Daycares with fomites? |
Custard mayo = Staph (enterotoxin and TSS toxin)
Fried rice = bacillus cereus Raw oysters = Vibrio and Hep A Raw eggs = Salmonella Canned beans = Clostridium Contaminated food = Listeria Daycares with fomites = Shigella |
|
shallow painful ulceraltion on genitals with swollen regional lymph nodes, requires chocolate agar to grow
What bug? |
Haemophilus ducrei, chancroid, requires X factor (hematin) like H. flu
|
|
Serpentine growth of thick ropelike cords
What is this, what bug? What does it mean? |
TB, CORD FACTOR (virulence factor of TB, inactivates neutrophils and damages mitochondria and releases TNF)
|
|
Migratory polyarthritis
What disease? |
Rheumatic ferver (JONES)
|
|
Child, Lethargy, Oliguria, Bloody diarrhea, elevated urea and creatinine, shitocytes
What disease |
HUS, undercooked beef, E. coli O157:H7
|
|
Custard mayo, what bug?
Fried rice, what bug? Raw oysters? (2) Raw eggs? Canned beans? Contaminated food? Daycares with fomites? |
Custard mayo = Staph (enterotoxin and TSS toxin)
Fried rice = bacillus cereus Raw oysters = Vibrio and Hep A Raw eggs = Salmonella Canned beans = Clostridium Contaminated food = Listeria Daycares with fomites = Shigella |
|
shallow painful ulceraltion on genitals with swollen regional lymph nodes, requires chocolate agar to grow
What bug? |
Haemophilus ducrei, chancroid, requires X factor (hematin) like H. flu
|
|
Serum mixed with cardiolipin, cholesterol and lecithin. Aggregation/flocculation of the sample occurs
What is this test? explain it? What bug? confirmatory test? explain it |
RPR (rapid plasmin reagin test), along with VDRL is used for high sensitivty screening for TREPONEMA bugs (syphilis, yaws).
RPR and VDRL tests for anticardiolipin antibodies (positive in lupus antiphospholipid syndrome) Diagnose with FTA-abs (antibodies directed against treponema) |
|
3 markers of active HepB infection?
What gives lifelong immunity to Hep B? What differs if its from a vaccine |
HBV DNA
HBsAg HBeAg Infection then immunity = IgG anti HBsAg as well as IgG anti HBcAg Vaccine = only HBsAg IgG |
|
IgG HepC core antigen gives immunity
True or false |
FALSE
relapsing and remitting hepatitis |
|
High fever, smoker, diarrhea, hyponatremia, confusion, cough and chest pain
What bug? What disease? Diagnosis? where is the bug found? |
Leigonella, Leigonnaire's disease
Urine antigen Water |
|
Indwelling catheters, prosthetic heart valves or orthapedic hardware can lead to what bug? What sequallae? Tx?
|
Staph epidermidis
Endocarditis, sepsis Vancomycin (most are resistant to penicillins and other beta lactams) |
|
MC neonatal sepsis/meningitis?
|
GBS, strep agalactiae
|
|
Bronchitis, pneumonia in elderly patients with COPD (3rd MC OM)
What bug |
Moraxella
|
|
Virulence factor for N. meningitidis?
|
LOS, analagous to LPS of gram - rods, acts as an endotoxin leading to toxic meingococal disease
LOS can be released in outer membrane vesicles that cause sepsis as well as waterhouse friedrichsen syndrome |
|
Difference between positive and negative selection
|
Occurs in the thymus. T-cells that are made must be able to bind to self MHC, only those survive. After that, they are tested against binding to self ANTIGENs, if they bidn to those they are destroyed (negative seelction
|
|
Hydrocephalus, intracranial calcifications, encephalitis, necrotizing brain lesions and white yellow chorioretinal lesions in both eyes
What caused this in baby? What should you tell the mother to avoid? Treatment? |
Congenital toxoplasmosis
avoid CAT LITTER Sulfadiazene and pyrimethamine |
|
How do IFN A/B work?
Do they upregulate innate or adaptive immune system? |
decrease viral replication, increase synthesis of antiviral proteins that impair translation of viral mRNA without impacing cellular mRNA
INNATE |
|
Tumbling motility, Can survive in cold refrigerated temperature
What bug? |
Listeria!
|
|
CNS lymphoma
What usually causes this? (disease and bug) |
HIV patients, EBV, causes a B-cell lymphoma in the brain
|
|
MC viral meningits?
Meningitis with accompanied lower leg weakness? |
Enteroviruses (cox, echo, polio)
POLIO (damages anterior horn cell bodies, anterior horn cell bodies = LMN, also seen in werdnighoffman in kids) |
|
Penetrating injury ==> crepitus
What happened? What bug? What toxin? |
C. perfringens, alpha toxin or phospholipase, gas gangrene
|
|
Which Hepatitis virus is DNA material?
Which hepatitis virus has no envelope? |
DNA = Hep B
Unenveloped = A and E |
|
Endocarditis after genitourinary procedures?
Endocarditis after colonic malignancy? How do you tell between these bacteria with a lab test |
GU procedures = Enterococcus faecilis or Poststreptococcus (survives in 6.5% NaCl)
Colonic malignancy = Strep Bovis (can't survive in 6.5% NaCl) Both are Gram +, cocci, catalase -, gamma hemolysis (none) |
|
Pseudoappendicitis
What bug? Why? |
Yersinia enterolitica, penetrates bowel mucosa and gains access to lymphatics and proliferates in the mesenteric nodes (RLQ pain)
|
|
Two causes of green diarrhea?
|
C diff
Yersinia enterolitica |
|
Gram - rods, lactose -, oxidase -
How do you use lab tests to discern |
Shigella, salmonella and proteus
Salmonella produces H2S Shigella does not |
|
IFN-y is essential for defence against what disease?
|
TB and other granuloma forming disease (required for macrophage maturation and phagolysosome formation)
|
|
Clustered gram + bacteria in clumps resembling chinese letters, stain with methylene blue, tonsillar exudates
Bug? |
C. Diphtheriae (exudates also seen in GAS and EBV mono)
|
|
Serum agglutinates sheep or horse erythrocytes. What test is this? If positive what disease?
what do you see on the blood smear in this disease? |
Monospot/Heterophile test
Positive = EBV mononucleosis If negative with symptoms think CMV Atypical lymphocytosis (big blue tinged cytoplasm) |
|
Where do you usually get monospot + mono?
monospot - mono? |
+ = EBV, close contact, kissing disease
- = CMV, usually from blood transfusions |
|
Latex particle agglutination positive CSF
What bug |
Cryptococcus, more specific than india ink
|
|
What abx do you use for bacterial meningitis caused by H. flu or strep pneumo?
Listeria? |
Ceftriaxone
Listeria = Ampicillin |
|
What bug has preformed toxin that is released via lysis? (2)
|
Clostridium BOTULINUM, STAPH aureus enterotoxin
(tetani is not preformed) |
|
Trouble swallowing, trouble seeing, trouble hearing, trouble moving joints
What disease? |
Botulinum neurotoxin!
|
|
Cutaneous/superficial candida infections is caused by what kind of dysfunction?
What about disseminated candida? |
Cutaneous = T-cell mediated (prevents localized spread)
Disseminated = neutrophil dysfunction (usually prevents hematogenous spread) |
|
Antibodies against cell outer covering causes it to swell
What test is this and what is it positive for? |
Quellung test, positive for capsullar bacteria (SHiN
|
|
Person has GAS pharyngitis, early antibiotic treatment prevents which sequellae?
|
Prevents rheumatic fever but does not prevent post strep glomerulonephritis which may still occur
|
|
Increased CD4/CD8 ratio indicates what disease process?
|
Granuloma formation (Sarcoid, TB.. etc.)
|