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;
95 Cards in this Set
- Front
- Back
What are the 3 stage of HIV?
|
1) acute
2) latent 3) advanced symptomatic (AIDS) |
|
How do you diagnose AIDS?
|
a (+) HIV test AND one of the following
1) less than 200 CD4 count 2) AIDS defining opportunistic infections (pneumocystis, CMV retinitis) 3) AIDS assoc malignancies (Kaposis sarcoma, brain lymphoma) 4) HIV complicating infections (extrapulmonary TB, HIV dementia) |
|
What are signs of HIV infections?
|
fever, weight loss, cachexia, night sweats
|
|
What is Hageman factor?
|
Factor XII, starts off intrinsic pathway
|
|
What test tests platelet fxn?
|
bleeding time
|
|
VWF binds to this other factor, and VWdz also causes def in it
|
VIII
|
|
What tests are positive in VWD?
|
PTT AND bleeding time
|
|
What tests are positive in hemophilia A and B?
|
increased PTT, normal bleeding time and PT
|
|
What can cause Vit K deficiency?
|
1) fat malabsorption
2) ABX (destroy gut flora which produce vit K 3) newborns bc they lack gut flora, are hypocoagulable for first few days 4) coumadin |
|
Why do you need to give heparin during first day of coumadin therapy?
|
Coumadin prevents Vit K dependent gamma carboxylation of proteins C and S, which normally impose tonic inhibition of factors V and VIII and have a 1/2 life of 24 hours. During first day of coumadin, proteins C and S are inhibited, so factors V and VIII will go haywire
|
|
Spherocytosis is due to deficiency in:
|
spectrin
|
|
What happens to RBCs in G6PD def?
|
they lyse when exposed to excess radicals (fava beans, sulfa drugs, quinine derivatives)
|
|
What is the most Common enzymopathy?
|
G6PD def
|
|
Sickle cell is due to single AA substitution of ____ for _____ at the _____ position of the ______ chain
|
valine for glutamate
6th AA position of the beta globin chain |
|
When is sickling promoted?
|
less than optimal oxygenation:
hypoxia, dehydration, acidosis |
|
What is Cooleys anemia?
|
B thal Major - didnt inherit an functional alleles --> SEVERE microcytic anemia
|
|
What is difference b/t indirect and direct Coombs?
|
Direct: detects ABs bound DIRECTLY to RBCs
Indirect: detects free floatiing ABs |
|
What is the test of choice to detect isoimmunization in Rh (-) females?
|
Indirect Coombs, bc would have neg Direct Coombs
|
|
What are some causes of B12 deficiency?
|
Diphylloborthrium latum
Poor diet Type A gastritis |
|
What GI findings are seen in Plummer Vinson anemia?
|
esophageal webs and dysphagias for solids only
|
|
Heinz bodies are a/w:
|
G6PD def
|
|
What do Howell-Jolly bodies indicate?
|
basophilic blue granules, indicate that RBCs are leaving bone marrow while still immature
|
|
Basophilic stippling indicates what type of poisoning?
|
lead
|
|
What special RBCs appear in iron overload 2ndary to deranged bone marrow function (not excess dietary Fe)?
|
siderocytes
|
|
What is Felty's syndrome?
|
variant of RA which includes immune mediated destruction of neutrophils via anti-neutrophil ABs
|
|
Difference b/t leukemia and lymphoma?
|
leukemia is fluid cancer, cant really image or pinpoint it
lymphoma is a solid tumor of cancerous lymphocytes |
|
What is the most common malignancy in children?
|
ALL
|
|
Where are Auer rods seen? What do they indicate?
|
AML
indicate evid of myeloid prolif |
|
What is the main thing with CML?
|
Philadelphia chromosome (9:22 translocation such that bcr-abl fusion gene is created
Also have low LAP = cells arent metabolically active |
|
What is (+) TRAP (tartrate-R-acid phosphatase) seen in?
|
Hairy cell leukemia
involves only B cells that develop hairy like projections |
|
What are some characteristics of Hodgkins lymphoma?
|
(+) Reed Sternberg cells (more = worse prognosis)
contiguous spread nodal involvement |
|
What are the 4 subtypes of Hodgkins lymphoma? Which are the worst?
|
1) lymphocyte predominance
2) nodular sclerosis 3) mixed cellularity 4) lymphocyte depletion 3 and 4 are worst because of more RS cells |
|
How does amantidine work?
|
it impairs uncoating for virus
|
|
What does interferon do to the cells in the body?
|
induces MHC-1 expression, increasing body's sensitivity toward and ability to eradicate virally infected cells.
|
|
Why is acyclovir only effective against HSV, VZV, EBV?
|
because the phosphorylation process can only be accomplished with viral thymidine kinase only present in those viruses
|
|
What are the three herpesviridae viruses?
|
HSV, VZV, EBV
|
|
Gancylcovir treats _____ because _____ is not needed for its phosphorylation. It is DOC for ____
|
CMV
thymidine kinase CMV retinitis |
|
How does AZT work?
|
it inhibits viral DNA synthesis after being incorporated into the growing viral DNA chain. It is a nuke
|
|
Protease inhibitors work by inhibiting cleavage of:
|
the "giant" protein (gag-pol-env) that HIV must cut apart in order to have the functional components of that protein
they end in -navir (ritonavir, indinavir) |
|
Non-nucleoside RTIs work by :
|
directly inhibiting reverse transcriptase
|
|
How do fusion inhibitors work?
|
prevent fusion between HIV virion and the cell
|
|
What do integrase inhibitors do?
|
prevent HIV viral integrase enzyme from inserting HIV DNA into Human DNA
|
|
How do CCR5 receptor antagonists work?
|
prevent entry of virus into cell
|
|
Foscarnet is an alternative to ____ in tx of _____
|
gancyclovir in tx of CMV
|
|
Drug of choice for herpes keratitis?
|
Trifluridine
|
|
Which are considered the atypical ribs?
|
1, 2, 11, 12
|
|
What are the three types of rib motion and which ribs have which?
|
Pump handle (1-5)
Bucket handle (6-10) Caliper (11-12) |
|
What are the primary muscles of respiration?
|
diaphragm and intercostals
|
|
Where does the diaphragm attach?
|
ribs 6-12 b/l, bodies and IV discs of L1-L3, xiphoid process
|
|
What Thoracic vertebrae is the inferior angle of the scapula at?
|
T7
|
|
Rule of Threes
|
T1-3- transverse process at same level as vertebra
T4-6- transverse process halfway between that vertebras spinous process and one above it T7-9- transverse process is next to SP of vertebra above it |
|
Which is the broadest and most curved rib?
|
rib 1
|
|
What is the DOC for vaginal candidiasis?
|
miconazole
|
|
DOC for blastomycosis?
|
itraconazole
|
|
DOC for aspergillosis?
|
voriconazole
|
|
What is ketoconazole the DOC for?
|
tinea versicolor
|
|
How does Amphotericin B cause fungal death?
|
binds to ergosterol, forming a pore in the fungal membrane through which electrolytes cross at will, causing severe electrolyte imbalances and fungal death.
|
|
This antifungal interacts with microtubules to disrupt mitotic spindles:
|
Griseofulvin
|
|
This drug is the DOC for onychoycosis. It works to inhibit ergosterol synthesis by inhibiting enzyme squalene epoxidase
|
Terbinafine
|
|
What is the DOC for vaginal candidiasis?
|
miconazole
|
|
DOC for blastomycosis?
|
itraconazole
|
|
Why would you use butenafine vs terbinafine?
|
same MOA, butenafine is not an oral agent (cream). This limits tox. It is DOC for all types of tinea except t. capitis
|
|
DOC for aspergillosis?
|
voriconazole
|
|
What is ketoconazole the DOC for?
|
tinea versicolor
|
|
How does Amphotericin B cause fungal death?
|
binds to ergosterol, forming a pore in the fungal membrane through which electrolytes cross at will, causing severe electrolyte imbalances and fungal death.
|
|
This antifungal interacts with microtubules to disrupt mitotic spindles:
|
Griseofulvin
|
|
This drug is the DOC for onychoycosis. It works to inhibit ergosterol synthesis by inhibiting enzyme squalene epoxidase
|
Terbinafine
|
|
Why would you use butenafine vs terbinafine?
|
same MOA, butenafine is not an oral agent (cream). This limits tox. It is DOC for all types of tinea except t. capitis
|
|
How does metronidazole work?
|
acts as electron receptor (like the metro, picks up electrons) creating compounds that readily bind to organisms proteins and DNA --> death
|
|
MOA of stibogluconate?
|
inhibits glycolysis
|
|
How do Albendazole and Mebendazole work?
|
bind to tubulin in the cells of roundworms, preventing microtubule formation
|
|
What is Permethrin cream used for?
|
head lice, public lice, scabies
|
|
What is Myiasis?
|
infestation of tissue by the larvae of flies (maggots)
|
|
Ziehl Neelsen stain is used for
|
acid fast bacteria
|
|
Prussian blue stains for
|
iron
|
|
Congo red stains for
|
amyloid
|
|
Giemsa stains for
|
blood smears
|
|
Where is strep viridans normal flora?
|
nasopharynx and mouth.
Risk of endocarditis after dental work |
|
ENDOtoxins cause
|
TNF, IL-1 release --> fever, shock
are heat stable |
|
Are TB and pseudomonoas obligate aerobes or anaerobes?
|
obligate aerobes
(reactivation of TB usually occurs in upper lung lobes where V/Q ratio highest |
|
Similarities and differences b/t cholera toxin and pertussis toxin?
|
Similarity- both stimulate adenylate cyclase
Difference- cholera activates Gs while pertussis activates Gi |
|
Which is catalase positive, staph or strep?
|
Staph
|
|
Which staph is coagulase pos?
|
Staph aureus
|
|
What are the 2 types of Neisseria?
|
N. Meningococcus- Gram stain of CSF is diagnostic
N. Gonococcus |
|
What are two signs of Tetanus?
|
Risus sardonicus- fixed smile and elevated eyebrows
Lock jaw |
|
Is Salmonella or Shigella motile?
|
Salmonella (remember salmon swim)
|
|
What infection results from dog/cat bites?
|
pasteurella
|
|
What bug is causes "walking pneumonia"?
|
chlamydia pneumonia
|
|
What kind of rash is classic in Rocky Mountain Spotted Fever?
|
rash that first appears on wrists and later spreads to trunk
|
|
What kind of diarrhea does V. Cholera cause?
|
rice-watery diarrhea
|
|
What is the most common cause of diarrhea in the US?
|
Campylobacter jejuni
|
|
Shigella is _____ times more infective than Salmonella
|
1000
|
|
Which bug looks like chinese characters?
|
Corynebacterium, causes diphtheria
|
|
What is most common cause of UTIs?
|
E coli
|
|
What kind of renal calculi does Proteus cause?
|
urease production --> ammonium calculi
|