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434 Cards in this Set
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- 3rd side (hint)
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what adverse effect is associated with bleomycin?
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pulmonary fibrosis
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Name 4 antineoplastic agents which are cell-cycle specific
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Methotrexate
5-Fluorouracil (5-FU) Cytarabine (Ara-C) 6-Mercaptopurine |
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What enzyme activates 6-Mercaptopurine?
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Hypoxanthine-guanine phosphoribosyltransferase (HGPRT)
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Name the antineoplastic alkylating agents
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Busulfan
Cyclophosphamide Nitrosoureas (lomustine, carmustine) Cisplastin, Carboplatin, Procarbazine |
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Which alkylating agent crosses the BBB?
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Nitrosoureas (lomustine, carmustine)
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Which antibiotics are antineoplastics?
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Bleomycin, doxorubicin
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Which antineoplastic is associated with nephrotoxicity?
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cisplastin, carboplastin
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Which antineoplastic is associated with cardiotoxicity?
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Doxorubicin
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Which antineoplastic is associated with pulmonary fibrosis?
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Bleomycin
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What's the mechanism of action of Doxorubicin?
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Intercalates DNA
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Tamoxifen increases the risk of which cancer?
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Endometrial carcinoma
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Name the antineoplastic plant alkaloids
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Vinblastine
Vincristin Paclitaxel Etoposide |
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Which antineoplastics are M-phase specific?
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vinblastine, vincristine, paclitaxel
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What's the mechanism of action of the plant alkaloids?
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Prevent the assembly of microtubules
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What's the mechanism of action of etoposide?
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Inhibits topoisomerase II
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What is the metabolite from cyclophosphamide responsible for the hemorrhagic cystitis?
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Acrolein
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What's the chromosomal translocation in Burkitt's lymphoma?
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t(8;14)
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What two genes are translocated in Burkitt's lymphoma?
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c-myc proto-oncogene (chromosome 8)
Antibody heavy chain (chromosome 14) |
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Which colon cancer is associated with napkin-like lesion and marked thickening of the mucosa layer of the rectum?
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Adenocarcinoma in the distal colon
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What's the Duke's classification used for?
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Used for stagin colorectal cancer
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Duke's classification B1 of colorectal cancer
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B1: Invasion into the muscularis propria but no metastases or lymph node involvement, 70-85% 5 year survival
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Muscularis, metastases, and lymph node involvement. Survival rate?
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Duke's classification A
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A: Tumor is limited to the mucosa with no lymph node or metastatic disease. 5 year survival is more than 90%
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Mucosal, metastases, and lymph node involvement. Survival rate?
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Duke's classification B2
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Invasion of the muscularis through the propria with no metastases or lymph node involvement. 55-65% 5 year survival
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Duke's classification C1 of colorectal cancer
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Invasion into the muscularis propria and lymph node but no metastases. 45-55% 5 year survival
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Duke's classification C2
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Invasion through the muscularis propria and lymph node but no distant metastases. 20-30% 5 year survival
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Muscularis propria, lymph node, and metastases involvement. Survival rate?
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Duke's classification D
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Distant metastatic disease of colon cancer. 5 year survival is less than 1%
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What's the normal function of the BRCA proteins?
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DNA repair
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Acquired and inherited colon cancer is associated with which genetic mutations?
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Loss of APC gene on 5q
Activation of k-ras on 12q Loss of DCC on 18q Loss of p53 on 17p |
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Which cancers are associated with mutation of VHL tumor suppressor gene on chromosome 3?
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von Hippel-Lindau
Hemangioblastoma (CNS and retina) Renal cell carcinoma |
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What's the Pickwickian syndrome?
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Obesity-Hypoventilation syndrome:
Patient is obese Daytime sleepiness Obstructive sleep apnea Awake hypoventilation (high pCO2) |
Sleep apnea
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What's the mechanism of action of acetazolamide in central sleep apnea?
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It causes metabolic acidosis, which stimulate a central compensatory response to increase ventilatory effort.
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What is the only nematode capable of increasing its numbers in the a host?
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Strongyloides stercoralis
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Which is the only worm capable of causing intestinal obstruction?
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Ascaris lumbricoides
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Large oval eggs with a lateral spine found in the stool
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Schistosoma
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Large round to oval eggs, with a thick mammillated shells found in the stool
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Ascaris lumbricoides
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Lemon-shaped eggs, with bipolar plugs found in the stool
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Trichuris trichiura
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Round eggs and proglottids filled with eggs found in the stool
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Taenia solium/saginata
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Small larvae found in the stool
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Strongyloides stercoralis
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Which region of the US will a patient most likely acquire an Ascaris lumbricoides infection?
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Southeast
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What is the pharmacologic treatment for Fasciola hepatica?
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Bethionol
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What's the pharmacologic treatment for Giardia lamblia, and Entamoeba histolytica
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Metronidazole
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Proliferating ducts and stromal cells are microscopic characteristic of which breast tumor?
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Fibroadenoma
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Cribiform pattern with neoplastic epithelial cells are histological characteristic of which breast cancer?
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Intraductal carcinoma of the breast
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What's the histological characteristic of intraductal carcinoma of the breast?
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Cribiform pattern with neoplastic epithelial cell
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What would a histological specime of fibrocystic change of the breast reveal?
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Cystically dilated ducts and stromal fibrosis
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What changes in ducts and stroma?
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What histological characteristics present in a phyllodes tumor differentiate it from a fibroadenoma?
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Increased cellularity
Enhanced mitotic rate Stromal overgrowth Nuclear pleomorphism Infiltrative borders |
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What percentage of congenital heart defects is made up of patent ductus arteriosus?
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10%
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HLA B27
Begins at the rectum and descending colon. Crypt abscesses Pseudopolyps Lead pipe colon High risk of colon cancer Toxic megacolon. Characteristics associated with? |
Ulcerative colitis
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Mechanism of action of infliximab
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TNF-alpha inhibitor
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What are the most common type of brain tumors?
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Astrocytomas
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What type of granuloma in sarcoidosis?
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Noncaseating
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What is Lofgren syndrome?
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A subtype of acute sarcoidosis
Hilar adenopathy on x-ray Erythema nodosum (tender red nodules, usually on the shins) |
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Albright’s Syndrome
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Polyostotic fibrous dysplasia
Precocious puberty Café au lait spots Short stature Young girls |
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Alport’s Syndrome
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Hereditary nephritis
Nerve deafness Type 4 collagen defect (basement membranes) |
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Alzheimer’s
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Progressive dementia
Tau proteins Neurofibrillary tangles, Apolipoprotein E4 allele Narrow gyri Wide sulci (atrophy) Occipital sparing Hydrocephalus ex vacuo Plaques in hippocampus and cortex, Acetylcholine Hiramo bodies (inrtacellular inclusion bodies in hippocampal cells) |
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Arnold-Chiari Malformation
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Cerebellar tonsil herniation
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Barrett’s
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Columnar metaplasia of lower esophagus (* risk of adenocarcinoma)
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Bartter’s Syndrome
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hyperreninemia
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Bernard-Soulier Disease
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Defect in platelet adhesion (abnormally large platelets & lack of von willenbrand factor receptor GP 1b platelet-surface glycoprotein)
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Berger’s Disease
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IgA nephropathy
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Bowen’s Disease
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carcinoma in situ on shaft of penis (* risk of visceral ca)
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Bronchiolitis
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RSV
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Bruton’s Disease
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X-linked agammaglobinemia
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Budd-Chiari
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Post-hepatic venous thrombosis
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Buerger’s Disease
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Acute inflammation of small, medium arteries * painful ischemia * gangrene * Japan * smoking
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Burkitt’s Lymphoma
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Small noncleaved cell lymphoma
EBV 8:14 translocation |
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Chediak-Higashi Disease
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Phagocyte Deficiency: Neutropenia
Albinism Cranial & peripheral neuropathy Repeated infections |
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Congenital adrenal hyperplasia
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21-hydroxylase deficiency: virilism, no cortisol, salt loss, hypotension 11-hydroxylase deficiency: virilism, no cortisol, salt retention, hypertension
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Conn’s Syndrome
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Primary aldosteronism
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Cori’s Disease
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Glycogen storage disease (debranching enzyme deficiency)
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Crigler-Najjar Syndrome
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Congenital hyperbilirubinemia (unconjugated) • glucuronyl transferase deficiency
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Crohn’s Disease
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IBD; ileocecum, transmural, skip lesions, lymphocytic infiltrate, granulomas (contrast to UC: limited to colon, mucosa & submucosa, crypt abscesses, pseudopolyps, * colon cancer risk)
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Croup: What virus?
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Parainfluenza
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Curling’s Ulcer
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Acute gastric ulcer associated with severe burns
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Cushing’s Disease/Syndrome
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Disease: hypercorticism 2* to * ACTH from pituitary (basophilic adenoma) • Syndrome: hypercorticism of all other causes (1* adrenal or ectopic)
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Cushing’s Ulcer
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Acute gastric ulcer associated with CNS trauma
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de Quervain’s Thyroiditis
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Self-limiting focal destruction (subacute thyroiditis)
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DiGeorge’s Syndrome
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Thymic hypoplasia
T-cell deficiency Hypoparathyroidism |
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Doll's Eyes Maneuver
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Patient comatose with intact brain stem
Eyes remain fixed and seem to move opposite the movement of the head |
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Dressler’s Syndrome
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Post-MI Fibrinous Pericarditis autoimmune
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Dubin-Johnson Syndrome
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Congenital hyperbilirubinemia (conjugated)
Striking brown-to-black discoloration of the liver |
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Edwards’ Syndrome
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Trisomy 18
Rocker-bottom feet Low ears Heart disease |
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Ehler’s-Danlos
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Defective collagen
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Eisenmenger’s Complex
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Late cyanotic shunt (R-->L)
Pulmonary HTN & RVH 2 to long-standing VSD, ASD, or PDA |
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Ewing Sarcoma
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Undifferentiated round cell tumor of bone
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Fanconi’s Syndrome
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Impaired proximal tubular reabsorption 2* to lead poisoning or Tetracycline
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Diagnosis of Rheumatic Fever
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2 major or 1 major and 2 minor
Major manifestations (mnemonic = CHANCE) Also try mnemonic "JONES" Carditis J= Joints PolyArthritis O = Carditis Chorea N= Nodules Erythema marginatum E = erythema Subcutaneous Nodules S = Syndenham's Chorea |
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MEN I
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3 P's (pituitary, parathyroid, and pancreas) plus adrenal cortex
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MEN II
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2 C's(carcinoma of thyroid and catacholamines [pheochromocytoma]) plus parathyroid for MEN IIa or mucocutaneous neuromas for MEN IIB(aka MEN III)
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INNERVATION OF PENIS
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* Parasympathetic causes erection. Sympathetic causes ejaculation. "Point and Shoot."
* "S2, 3, 4 keep the penis off the floor" * Innervation of the penis by branches of the pudendal nerve, derived from spinal cord levels S2-4 |
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HYPERSENSITIVITY REACTIONS
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* Type I Anaphylaxis
* Type II Cytotoxic-mediated * Type III Immune-complex * Type IV Delayed hypersensitivity |
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WBC Count
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"Never Let Mom Eat Beans" and "60, 30, 6, 3, 1"
"Nice Ladies Make Easter Bread" and "60, 30, 6, 3, 1" * Neutrophils 60% * Lymphocytes 30% * Monocytes 6% * Eosinophils 3% * Basophils 1% |
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5 SIGNS OF INFLAMMATION
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* Redness/Erythema Italic text(Rubor)
* Raised temperature Italic text(Calor) * Swelling Italic text(Tumor) * Pain Italic text(Dolor) * Loss of Function Italic text(Functio Laesa) |
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Presentation of HYPO-kalemia:
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EKG S-T wave depression (sometimes with T and U waves)
Arrythmias Heart block Muscle weakness Hypo-reflexia |
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Presentation of HYPER-kalemia:
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Widened QRS interval
Ventricular tachycardia Asystole Muscle weakness (paralysis) Hypo-reflexia Mental confusion Irritability |
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Causes of Hyper-Calcemia
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PAM SCHMIDT OR MISHAP
Paget's Disease Malignancy Amyloid Intoxication (hypervitaminosis) Multiple Myeloma Sarcoidosis Sarcoid Hyperparathyroidism Cancer Alkali ( Milk ) syndrome Hormonal (para-thyroid) Paget's Disease bone Milk-alkali Syndrome Immobilization D-vitamin overdose Thyrotoxicosis also consider Addison's Disease, thiazide diuretics and simple lab error |
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Causes of Metabolic Acidosis
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M U D P I L E S
Methanol poisoning Uremia Diabetic Keto-acidosis Para-aldehyde ingestion Ischemia Lactic Acidosis Ethanol poisoning Salicylate ingestion |
MUDPILES
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Deep Reflexes
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Biceps (C5-6) elbow flexion
Barchio-radialis (C5-6) elbow flexion & supination Triceps (C7) elbow extension Patellar (L3-4) knee extension = kneee jerk Achilles (S1) plantar flexion = ankle jerk |
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BRANCHES OF FACIAL NERVE
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Temporal, Zygomatic, Buccal, Mandibular, Cervical
* Two Zebras Bought My Car * Two Zebras Bit My Cookie * To Zanzibar By Motor Car * Ten Zulus Buggered My Cat |
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CERVICAL SPINAL NERVES
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* c345 keeps the phrenic alive (innervation of phrenic nerve)
* c345 keep the diaphragm alive (innervation of diaphragm) * c5-6-7 raise your arms to heaven (nerve roots of long thoracic nerve innervate serratus anterior and if severed you see "winging" of the scapula) |
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Order of things in the Femoral Triangle
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* "N(AVEL)"
* Nerve, Artery, Vein, Empty space, Lymphatics NOTE: Parenthesis includes things contained in the femoral sheath. |
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Nucleotides
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purines vs. pyrimidines "Guardian Angels are Pure, with two Wings": G and A are Purines, with two Rings.
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What's the genetic defect in Cri-du-chat syndrome?
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Chromosomal deletion of 5p
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Marfan syndrome features
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MARFAN:
Mitral valve prolapse Aortic Aneurysm Retinal detachment Fibrillin Arachnodactyly Negative Nitroprusside test (differentiates from homocystinuria) |
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Cell cycle stages
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"Go Sally Go! Make Children!": G1 phase (Growth phase 1) S phase (DNA Synthesis) G2 phase (Growth phase 2) M phase (Mitosis) C phase (Cytokinesis)
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Tay Sach's features
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SACHS:
Spot in macula Ashkenazic Jews CNS degeneration Hex A deficiency Storage disease Extra details with TAY: Testing recommended Autosomal recessive/ Amaurosis Young death (<4 yrs) |
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Carnitine shuttle: function
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The carnitine shuttle transports the acyl group from cytosolic fatty acyl CoA molecules across the inner mitochondrial membrane, which is impermeable to CoA, returning it to mitochondrial CoA molecules. The newly formed mitochondrial fatty acyl CoA molecules can then undergo -oxidation.
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A-P-G-A-R:
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* A - appearance (color)
* P - pulse (heart rate) * G - grimmace (reflex, irritability) * A - activity (muscle tone) * R - respiratory effort |
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Takayasu's diz
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Pulseless diz, therefore when you have Takayasu's, I can't Tak'a yu pulse.
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CAGE--alcohol use screening
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* Have you ever felt it necessary to CUT DOWN on your drinking?
* Has anyone ever told you they were ANNOYED by your drinking? * Have you ever felt GUILTY about your drinking? * Have you ever felt the need to have a drink in the morning for an EYE OPENER? |
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P-Q-R-S-T--eliciting and HPI and exploring symptoms
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* P--palliative or provocative factors for the pain
* Q--quality of pain(burning, stabbing, aching, etc.) * R--region of body affected * S--severity of pain(usually 1-10 scale) * T--timing of pain(eg.-after meals, in the morning, etc.) |
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Huntington’s brain changes
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Progressive degeneration of caudate nucleus, putamen & frontal cortex;
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AD Hunter’s
enzyme deficiency? |
Decreased iduronosulfate sulfatase
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Hurler’s
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Decreased alpha-L-iduronidase
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Niemann-Pick
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Lysosomal Storage Disease sphingomyelinase deficiency • “foamy histiocytes”
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Angiomatosis
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Little knots of capillaries in the retina and various organs
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What are the features of von-Hippel Lindau
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Abnormal growth of tumors in parts of the body which are rich in blood supply.
1) Angiomatosis 2) Hemangioblastoma 3) Pheochromocytoma 4) Renal cell carcinoma 5) Pancreas |
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What's the MoA and site of action of acetazolamide?
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It inhibits carbonic anhydrase, which mediates reabsorption of NaHCO3 in the PCT
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Thiazide effect on Ca2+ excretion
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It reduces Ca2+ excretion
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Site of action of thiazide diurectics
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Distal convoluted tubule
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MoA of thiazides
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Inhibit NaCl reabsorption
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Acetazolamide toxicity
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Hyperchloremic metabolic acidosis
Neuropathy |
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Mannitol MoA
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Osmotic diuretic, incr tubular fluid osmolarity ---> incr urine flow
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Mannitol toxicities
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Toxicities:
Pulmonary edema Dehydration Contraindications: Anuria CHF |
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Furosemide MoA and site of action
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Inhibits cotransport system (Na+, K+, 2Cl-)
Abolishes hypertonicity of medulla, preventing concentration of urine |
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Furosemide site of action
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Thick ascending loop of Henle
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K+ sparing diuretics
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Spironolactone
Triamterene Amiloride Eplereone |
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Spironolactone MoA
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Competitive aldosterone receptor antagonist
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Spironolactone SoA
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Cortical collecting tubule
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Triamterene and amiloride MoA
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Block Na+ channels
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Triamterene and amiloride SoA
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Cortical collecting tubule
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Spironolactone toxicity
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Gynecomastia
Antiandrogen effects |
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Which diuretics decr pH?
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Carbonic anhydrase inhibitors
K+ sparing diuretics |
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Which diuretics incr pH?
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Loop diuretics
Thiazides |
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Loop diuretics effect on urine Ca+
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Increase Ca+ urine
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List of ACE inhibitors
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Captopril
Enalapril Lisinopril |
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ACE inhibitors toxicities
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CAPTOPRIL:
Cough Angioedema Proteinuria Taste changes hypOtension Pregnancy problems (fetal renal damage) Rash Increased renin Lower angiotensin II --Hyperkalemia-- |
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Losartan MoA
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Not an ACE inhibitor
Angiotensin II receptor antagonist |
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Positive Predictive Value (PPV)
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Number of true positives divided by the number of people who tested positive for the disease
The probability of having a condition given a positive test |
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Negative Predictive Value (NPV)
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Number of true negatives divided by the number of people who tested negative for the disease
The probability of not having the condition given a negative test |
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Odds ratio
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Odds of having disease in exposed divided by odds of having disease in unexposed
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Type I error (alpha)
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Stating that there is an effect or difference when none exists (to mistakenly accept the experimental hypothesis and reject the null hypothesis)
p is judged against alpha, a preset level of significance (usually <.05) p = probability of making a type I error False Positive |
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p<.05
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There is less than a 5% chance that the data will show something that is not really there.
alpha = you "saw" a difference that did not exist |
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Type II error (beta)
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Stating that there is not an effect or difference when one exist (to fail to reject the null hypothesis when in fact Ho is false).
Beta is the probability of making a type II error |
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Type II error (beta)
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You did not "see" a difference that does exist
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Kimmelstiel-Wilson
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Increase in mesangial matrix by marked nodular accumulations
Seen in: Diabetic Nephropathy |
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Rapidly progressive (crescentic) glomerulonephritis
Pathological findings? |
Extensive capillary damage ---> accumulation of cells and fibrinous changes in Bowman's space
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Membranoproliferative glomerulonephritis
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Mesangial proliferation
Thickening of the peripheral capillary walls by immune deposits Mesangial interposition into the capillary wall ---> tram-track appearance on light microscopy |
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Focal segmental glomerulosclerosis
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Nephrotic syndrome
Young Hypertensive African-American Glomerular sclerosis (Obliteration of capillary lumen) Focal (some glomeruli affected) Segmental (only parts of the glomerulus) |
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NephrItic Syndrome
Diseases |
1) Acute poststreptococcal glomerulonephritis
2) Rapidly progressive (crescentic) glomerulonephritis 3) Goodpasture's syndrome (type II hypersenstivity) 4) Membranoproliferative glomerulonephritis 5) IgA nephropathy (Berger's disease) 6) Alport's syndrome |
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NephrOtic syndrome
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O = prOteinuria
Massive proteinuria (frothy urine) Hypoalbuminemia Peripheral and periorbital edema Hyperlipidemia |
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NeprhOtic syndrome diseases
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1) Membranous glomerulonephritis
2) Minimal change disease (lipoid neprhosis) 3) Focal segmental glomerular sclerosis 4) Diabetic nephropathy 5) SLE 6) Amyloidosis-IF |
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NephrItic Syndrome
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I = Inflammation
Hematuria Hypertension Oliguria Azotemia |
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Anti-D agglutination
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Indicates Rh-positive
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CREST syndrome
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C: Calcinosis
R: Raynaud's E: Esophageal dysmotility S: Sclerodactyly T: Telangiectasia Anticentromere antibody positive |
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Reiter's syndrome
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Urethritis
Conjunctivitis/Anterior uveitis Arthritis |
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anti-Scl-70
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Diffuse slceroderma
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Anti-mitochondrial antibody
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Primary biliary cirrhosis
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Anti-dsDNA, and-Smith
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Specific for SLE
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Antihistone
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Drug-induced lupus
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Antineutrophil (C-ANCA, P-ANCA)
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Vasculitis
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Stop codons
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UAA
UGA UAG |
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Primary transcript RNA
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pre-mRNA (hnRNA)
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Termination of transcription in prokaryotes
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Stem and loop + UUUUU
Stem and loop + rho factor |
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Initiation of transcription in prokaryotes
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Promoter (-10) TATAAT and (-35) sequence
Sigma initiation subunit(s) required to recognize promoter |
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Initiation of transcription in eukaryotes
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Promoter (-25) TATA and (-70) CAAT
Transcription factors (TFIID) bind promoter |
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Turner's syndrome genotype
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XO
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Turner's syndrome phenotype
|
Women
Short Webbed neck Poorly developed secondary sexual characteristics Ovarian dysgenesis (streak ovaries) "Hugs and kisses"(XO) from Tina Turner (female) |
|
|
|
Aorta in Turner's syndrome
Aorta in Marfan's syndrome |
Turner's: Coarctation of the aorta
Marfan's: Aortic dissection |
|
|
|
Klinefelter's syndrome genotype
|
XXY genotype
|
|
|
|
Testicular feminization syndrome defect
|
Dihydrotestosterone receptor defect
|
|
|
|
Testicular feminization syndrome phenotype
|
Normal appearing female
Amenorrheic |
|
|
|
Klinefelter's syndrome phenotype
|
Male
Testicular atrophy Eunichoid body shape Tall (long extremities) Gynecomastia Female hair body distribution |
|
|
|
Klinefelter's syndrome testicular pathology
|
Dysgenesis of seminererous tubules ---> Decr inhibin ---> Incr FSH
Abnormal Leydig cell function ---> Decr testosterone ---> Incr LH ---> Incr estrogen |
|
|
|
Alternative Splicing of Eukaryotic mRNA
|
Primary transcript:
Is spliced differently in different cell types to produce two or more variants of a protein from the same gene |
|
|
|
Silent mutation
What effect on codon and protein? |
New codon specifies same amino acid
No effect on protein |
|
|
|
Missense mutation
|
New codon specifies different amino acid
Possible decrease in function; variable effects on protein |
|
|
|
Nonsense mutation
Effect on codon and protein |
New codon is stop codon
Shorter than normal; usually nonfunctional protein |
|
|
|
Frameshift mutation
|
Deletion or addition of a base
Usually nonfunctional protein; often shorter than normal |
|
|
|
Large segment deletion (unequal crossover in meiosis) mutation
|
Loss of function; shorter than normal or entirely missing protein
|
|
|
|
Splice donor or acceptor mutation
|
Variable effects on protein; ranging from addition or deletion of a few amino acids to deletion of an entire exon
|
|
|
|
Triplet repeat expansion mutation
|
Expansions in coding regions cause protein product to be longer than normal and unstable
Disease shows anticipation in pedigree. |
|
|
|
Sickle cell anemia type of mutation
|
Missense point mutation
|
|
|
|
a-Thalassemia type of mutation
|
Unequal crossover has deleted one or more a-chain hemoglobin genes from chromosome 16
|
|
|
|
Mutations in Splice Sites
|
Mutations in splice sites affect the accuracy of intron removal from hnRNA during posttranscriptional processing
* If a splice site is lost through mutation, spliceosomes may: 1. Delete nucleotides from the adjacent exon. 2. Leave nucleotides of the intron in the processed mRNA. 3. Use the next normal upstream or downstream splice site, deleting an exon from the processed mRNA. |
|
|
|
b-thalassemia, Gaucher’s disease, and Tay-Sachs type of muatiion
|
Mutations in splice sites
|
|
|
|
Huntington’s disease
Fragile X syndrome Spinobulbar muscular atrophy Myotonic dystrophy What type of mutation? |
Trinucleotide Repeat Expansion
|
|
|
|
aminoacyl-tRNA synthetases
|
Amino acids are “charged” onto tRNA by aminoacyl-tRNA synthetases
|
|
|
|
The Wobble Hypothesis
|
The wobble hypothesis states that the third position (3' end) of the codon on mRNA and the first position (5' end) of the anticodon on tRNA are bound less tightly than the other base pairs, and, therefore, allow unusual base pairings to occur.
|
|
|
|
Bone marrow appearance in aplastic anemia
|
Hypocellular
|
|
|
|
RBC appearance in thalassemia
|
Hypochromic that may have a target appearance
|
|
|
|
What's the chemical most commonly associated as the cause of aplastic anemia?
|
Benzine
|
|
|
|
What lung disorders are usually caused by asbestos?
|
Pulmonary fibrosis
Mesothelioma Lung cancer |
|
|
|
RBC appearance in lead poison anemia
|
Hypochromic Microcytic
|
|
|
|
What drugs are usually associated as the cause of aplastic anemia?
|
Chloramphenicol
Phenylbutazone Gold |
|
|
|
What's the multidrug treatment for Mycobacterium leprae?
|
Rifampin
Clofazimine Dapson |
|
|
|
What's the MoA of dapson?
|
Inhibits bacterial synthesis of dihydrofolic acid
|
|
|
|
Tricky T's
|
Chlamydia trachomatis -- bacteria , STD
Trichomonas vaginalis -- protozoan, STD Trichinella spiralis -- worm in undercooked meat Trypanosoma -- causes Chaga's diesease (T. cruzi) or African sleeping sickness Treponema -- spirochete; causes syphilis (T. pallidum) or yaws (T. pertenue) |
|
|
|
Trichomoniasis
|
Vaginitis
Strawberry-colored mucosa |
|
|
|
Vaginitis
|
Foul-smelling
Greenish discharge Itching Burning |
|
|
|
Common organisms which cause vaginal infections
|
Itchiness Discharge
C. Albicans: yes white T. Vaginalis: yes yellow Gardenerella vaginalis: white/gray |
|
|
|
Giardiasis
|
Bloating
Flatulence Foul-smelling diarrhea Transmxn: Cysts in water Dx: Trophozoites or cysts in stool |
|
|
|
Giardiasis treatment
|
Metronidazole
|
|
|
|
3 Protozoans usually transmitted by cysts in water
|
Entamoeba histolytica
Giardia lamblia Cryptosporidium |
|
|
|
Metronidazole MoA
|
Forms toxic metabolites in the bacterial cell
|
|
|
|
Metronidazole clinical use
|
Giardia
Entamoeba Trichomonas (GET on the METRO) Gardnerella vaginalis Anaerobs (bacteroides, clostridium) |
|
|
|
Triple therapy against H. pylori
|
Bismuth
Amoxicillin Metronidazole (BAM) |
|
|
|
Anti-TB drugs
|
Streptomycin
Pyrazinamide Isoniazid (INH) Rifampin Ethambutol (INH-SPIRE [inspire]) Cycloserine (2nd-line therapy) |
|
|
|
What drug is used for TB prophylaxis?
|
Isoniazid (INH)
|
|
|
|
Isoniazide (INH):
MoA |
Decreases the synthesis of mycolic acids
|
|
|
|
Isoniazide (INH):
Toxicity |
Hemolysis if G6PD deficient
Neurotoxicity Hepatotoxicity SLE-like syndrome Pyridoxine (vit B6) can prevent neurotoxicity INH: Injures Neurons and Hepatocytes |
|
|
|
Bacterial vaginitis causative agent
|
Gardnerella vaginalis
|
|
|
|
Dangerous infections during pregnacy
|
ToRCHeS:
Toxoplasma Rubella CMV HSV/HIV Syphilis |
|
|
|
Coxsackie B virus causes what heart condition?
|
Myocarditis
|
|
|
|
5 major rheumatic fever criteria
|
Carditis
Migratory polyarthritis Subcutaneous nodules Sydenham chorea Erythema marginatum |
|
|
|
Ebstein's anomaly
|
Anomalous attachment of the tricuspid leaflets
Downward displacement of the tricuspid valve into the right ventricle Tricuspid regurgitation |
|
|
|
Aschoff body
|
Rheumatic fever
Focal interstitial myocardial inflammation Large cells (Anitschkow myocytes) Aschoff cells (multinucleated giant cells) |
|
|
|
Libman-Sacks lesions
|
Small vegetations that occur on valvular heart tissue
Associated with endocarditis in SLE |
|
|
|
Calcium channel blocker agents and MoA
|
Diltiazem
Nifedipine Verapamil Block voltage-dependent L-type calcium channels |
|
|
|
X-ray findings in sarcoidosis
|
Bilateral hilar lymphadenopathy
|
|
|
|
Sarcoidosis findings
|
GRAIN
Gammaglobulinemia Rheumatoid arthritis ACE increase Interstitial fibrosis Noncaseating granuloma |
|
|
|
Lung disease in sarcoidosis
|
Restrictive lung disease
|
|
|
|
ANCA positive vasculitidies
|
Polyarteritis nodosa
Wegener's granulomatosis Microscopic polyangiitis 1o pauci-immune crescentic glomerulonephritis Churg-Strauss syndrome |
|
|
|
Cafe-au-lait spots
|
Neurofibromatosis
|
|
|
|
Cerebriborm nuclei
|
Mycosis fungoides (cutaneous T-cell lymphoma)
|
|
|
|
Charcot's triad - Multiple sclerosis
|
Multiple sclerosis
* Nystagmus * Intention tremor * Scanning speech |
|
|
|
Charcot's triad - Cholangitis
|
Cholangitis
* Jaundice * RUQ pain * Fever |
|
|
|
Charcot-Leyden crystals
|
Bronchial asthma (eosinophil membranes)
|
|
|
|
Cotton-Wool spots
|
Chronic hypertension
|
|
|
|
Curling's ulcer
|
Acute gastric ulcer associated with severe burns
|
|
|
|
Currant jelly sputum - What organism?
|
Klebsiella
|
|
|
|
Ghon focus is an indication of?
|
Primary TB
|
|
|
|
Glanzmann's thrombasthenia
|
Defect in platelet aggregation
|
|
|
|
Hand-Schuller-Disease
|
Chronic progressive hitiocytosis
|
|
|
|
Heterophil antibodies
|
Infectious mononucleosis (EBV)
|
|
|
|
High-output cardiac failure (dilated cardiomyopathy)
|
Wet beriberi (thiamine, vit B1 deficiency)
|
|
|
|
Homer Wright rosettes
|
Neuroblastoma
|
|
|
|
Honeycomb lung on x-ray
|
Interstitial fibrosis
|
|
|
|
Howell-Jolly bodies
|
Splenectomy (or nonfunctional spleen)
|
|
|
|
Increased uric acid levels
|
Gout
Lesch-Nyhan syndrome Myeloproliferative disorders Loop and thiazide diuretics |
|
|
|
Kartagener's syndrome
|
Dynein defect
|
|
|
|
Krukenberg tumor
|
Gastric adenocarcinoma with ovarian metastases
|
|
|
|
Lesch-Nyhan syndrome what enzyme deficiency
|
HGPRT deficiency
|
|
|
|
Libman-Sacks disease
|
Endocarditis associated with SLE
|
|
|
|
Lisch nodules
|
Neurofibromatosis (von Recklinghausen's diease)
|
|
|
|
Lumpy-bumpy appearance of glomeruli on immunofluorescence
|
Poststreptococcal glomerulonephritis
|
|
|
|
Monoclonal antibody spike
|
Multiple myeloma (called the M protein; IgG or IgA)
MGUS Waldenstrom's (M protein = IgM) macroglobulinemia |
|
|
|
Needle-shaped, negative birefringent crystals
|
Gout
|
|
|
|
Nephritis
Cataracts Hearing loss |
Alport's syndrome
|
|
|
|
Malignant mesothelioma
|
Occupational exposure to asbestos
|
|
|
|
"orphan annie" nuclei
|
Papillary carcinoma of the thyroid
|
|
|
|
Osler's nodes
|
Endocarditis
|
|
|
|
Painless jaundice
|
Pancreatic cancer (head)
|
|
|
|
Palpable purpura on legs and buttocks
|
Henoch-Schonlein purpura
|
|
|
|
Pancoast's tumor
|
Bronchogenic apical tumor associated with Horner's syndrome
|
|
|
|
Periosteal elevation on x-ray
|
Pyogenic osteomyelitis
|
|
|
|
Peutz-Jeghers syndrome
|
Benign polyposis
|
|
|
|
Peyronie's diasease
|
Penile fibrosis
|
|
|
|
Pink puffer
|
Emphysema (centroacinar [smoking], panacinar [a1-antitrypsin deficiency)
|
|
|
|
Podagra
|
Gout (MP joint of hallux)
|
|
|
|
Plummer-Vinson syndrome
|
Esophageal webs with iron deficiency anemia
|
|
|
|
Positive anterior "drawer sign"
|
Anterior cruciate ligament injury
|
|
|
|
Pseudorosettes
|
Ewing's sarcoma
|
|
|
|
Rash on palms and soles
|
2o syphilis
Rocky mountain spotted fever |
|
|
|
RBC casts in urine
|
Acute glomerulonephritis
|
|
|
|
Red urine in the morning
|
Paroxysmal nocturnal hemoglobinuria
|
|
|
|
Increased Reid index
|
Chronic bronchitis
|
|
|
|
Reinke crystals
|
Leydig cell tumor
|
|
|
|
Renal cell carcinoma + cavernous hemangiomas + adenomas
|
von Hippel-Lindau disease
|
|
|
|
Renal epithelial casts in urine
|
Acute toxic/viral nephrosis
|
|
|
|
Rhomboid crystals, positively birefringent
|
Pseudogout
|
|
|
|
Rib notching
|
Coarctation of the aorta
|
|
|
|
Roth's spots in retina
|
Endocarditis
|
|
|
|
Rotor's syndrome
|
Congenital conjugated hyperbilirubinemia
|
|
|
|
Rouleaux formation (RBCs)
|
Multiple myeloma
|
|
|
|
Russell bodies
|
Multiple myeloma
|
|
|
|
S3
|
Left to right shunt (VSD, PDA, ASD)
Mitral regurgitation LV failure (CHF) |
|
|
|
S4
|
Aortic stenosis
Hypertrophic subaortic stenosis |
|
|
|
Schiller-Duval bodies
|
Yolk sac tumor
|
|
|
|
Sezary syndrome
|
Cutaneous T-Cell lymphoma
|
|
|
|
Shwartzman reaction
|
Neisseria meningitidis
|
|
|
|
Signet-ring cells
|
Gastric carcinoma
|
|
|
|
Simian crease
|
Down syndrome
|
|
|
|
Sipple's syndrome
|
MEN type IIa
|
|
|
|
Smudge cell
|
CLL
|
|
|
|
Smith antigen
|
SLE
|
|
|
|
Soap bubble on x-ray
|
Giant cell tumor of bone
|
|
|
|
Spike and dome on EM
|
Membranous glomerulonephritis
|
|
|
|
Spitz nevus
|
Benign juvenile melanoma
|
|
|
|
Splinter hemorrhages in fingernails
|
Endocarditis
|
|
|
|
Starry-sky pattern
|
Burkitt's lymphoma
|
|
|
|
Strawberry tounge
|
Scarlet fever
|
|
|
|
String sign on x-ray
|
Crohn's disease
|
|
|
|
Subepithelial humps on EM
|
Poststreptococcal glomerulonephritis
|
|
|
|
Suboccipital lymphadenopathy
|
Rubella
|
|
|
|
Sulfur granules
|
Actinomyces israelii
|
|
|
|
Systolic ejection murmur (crescendo-decrescendo)
|
Aortic valve stenosis
|
|
|
|
t(14;18)
|
Follicular lymphomas (bcl-2 activation)
|
|
|
|
Tendon xanthomas
|
Familial hypercholesterolemia
|
|
|
|
Thumb sign on lateral x-ray
|
Epiglottitis (Haemophilus influezae)
|
|
|
|
Thyroidization of kidney
|
Chronic bacterial pyelonephritis
|
|
|
|
Tram-track appearance on LM
|
Membranoproliferative glomerulonephritis
|
|
|
|
Trousseau's sign
|
Visceral cancer
Pancreatic adenocarcinoma (migratory thrombophlebitis) Hypcalcemia (carpal) |
|
|
|
Virchow's node
|
Left supraclavicular node enlargement from metastic carcinoma of the stomach
|
|
|
|
Virchow's triad
|
Pulmonary embolism:
1) Blood stasis 2) Endothelial damage 3) Hypercoagulation |
|
|
|
von Recklinghausen's disease of bone
|
Osteitis fibrosa cystica (brown tumor)
|
|
|
|
Wallenberg's syndrome
|
PICA thrombosis
|
|
|
|
Waxy casts
|
Chronic end-stage renal disease
|
|
|
|
WBC casts in urine
|
Acute pyelonephritis
|
|
|
|
WBCs in urine
|
Acute cystitis
|
|
|
|
Wermer's syndrome
|
MEN type I
|
|
|
|
Whipple's disease
|
Malaborption syndrome caused by Tropheryma whippelii
|
|
|
|
Wire loop appearance on LM
|
Lupus nephropathy
|
|
|
|
Xanthochromia (CSF)
|
Subarachnoid hemorrhage
|
|
|
|
Xerostomia + arthritis + keratoconjunctivitis sicca
|
Sjogren's syndrome
|
|
|
|
Zenker's diverticulum
|
Upper GI diverticulum
|
|
|
|
Zollinger-Ellison syndrome
|
Gastrin-secreting tumor associated with ulcers
|
|
|
|
Death in CML
|
Blast crisis
|
|
|
|
Death in SLE
|
Lupus nephropathy
|
|
|
|
Ejection click
|
Aortic/pulmonic stenosis
|
|
|
|
Glomerulonephritis (adults)
|
IgA nephropathy (Berger's disease)
|
|
|
|
Which hepatitis viruses lead to Hepatocellular carcinoma?
|
Cirrhotic liver (often associated with hepatitis B and C)
|
|
|
|
Holosystolic murmur
|
VSD
Tricuspid regurgitation Mitral regurgitation |
|
|
|
Infection in burn victims
|
Pseudomonas
|
|
|
|
Leukemia (adults)
|
AML
|
|
|
|
MI
|
Atherosclerosis
|
|
|
|
Mitral valve stenosis
|
Rheumatic heart disease
|
|
|
|
Nephrotic syndrome (adults)
|
Membranous glomerulonephritis
|
|
|
|
Nephrotic syndrome (kids)
|
Minimal change disease (associated with infections/vaccinations; treat with corticosteroids)
|
|
|
|
Opening snap
|
Mitral stenosis
|
|
|
|
Osteomyelitis with IVDA: causative agent
|
Pseudomonas
|
|
|
|
Causes of pancreatitis (acute)
|
EtOH and gallstones
|
|
|
|
Glutamate inhibitors
|
Topiramate
Felbamate |
|
|
|
Genetic d/o of two or more chromosomes in men
|
Klinefelter's syndrome
|
|
|
|
Genetic defects of SCID
|
1) Recombinase-activating gene (RAG-1 and RAG-2) on chr. 11
2) ADA deficiency on chr. 20 3) Interleukin 2 receptor gama-chain (IL-2Rg)deficiency on chr. X 4) Janus-associated kinase 3 (JAK3) chr. 19 5) DNA-dependent protein kinase (PK) deficiency on chr. 8 |
|
|
|
X-linked recessive d/o
|
1) Fragile X
2) Duchenne's 3) Hemophelia A and B 4) Fabry's 5) G6PD 6) Hunter's syndrome 7) Ocular albanism 8) Lesch-Nyhan syndrome 9) Bruton's agammaglobulinemia 10) Wiskott-Aldrich syndrome |
|
|
|
Loss of gene for Wiskott-Aldrich syndrome protein (WASP)
|
Causes disturbance in actin in the cytoskeleton
|
|
|
|
Only d/o with smaller than normal platelets
Impaired CD43 gp Triad: eczema, recurrent infections, and thrombocytopenia Increased lymphoreticular malignancy |
Wiskott-Aldrich syndrome
|
|
|
|
Media to grow cryptococcosis
|
Sabourd's medium
or Niger seed agar |
|
|
|
Buddding of Cryptococcus
|
Narrow-based unequal budding
|
|
|
|
Flucytosine MoA
|
Inhibits DNA synthesis by:
conversion to fluorouracil which competes with uracil |
|
|
|
Requires:
Telurite medium Loffler's medium Blood agar |
C. diphtheriae
|
|
|
|
Inactivates elongation factor (EF-2)
|
Diphtheria toxin
|
|
|
|
8 y/o girl with congenital duplicate thumb, cafe-au-lait spots, and anemia
Most likely diagnosis? |
Fanconi's anemia
|
|
|
|
Gram + spore formers
|
Bacillus anthracis
Clostridium perfringens Clostridium tetani |
|
|
|
Ursoldiol
|
Prevents formation of cholesterol gallstones through three mechanisms:
1) Decr hepatic secretion of cholesterol bile 2) Decr cholesterol synthesis by inhibiting HMG-CoA reductase 3) Decr reabsorption of cholesterol by the intestine |
|
|
|
Elliptocytosis Treatment
|
Splenectomy
|
|
|
|
Pantothenic acid
|
B vitamin
Combines with cysteine and ATP to form CoA |
|
|
|
Zanamivir (Relenza)
|
Reversible inhibits neuraminidase (NA) of influenze A and B
|
|
|
|
Oseltamivir (Tamiflu)
|
prodrug that is converted into an active neuraminidase inhibitor
|
|
|
|
Schistosomiasis treatment
|
Praziquantel
|
|
|
|
Slow-reacting substance of anaphylaxis
|
LTB4
LTC4 LTD4 |
|
|
|
Warfarin (Coumadin) MoA
|
Inhibits epoxide reductase
|
|
|
|
Shigellosis (Bacillary dysentery)
Affected bowel area Diarrhea Treatment |
Colon
Profuse, initially nonbloody turning to bloody Tetracyclines, ciprofloxacin |
|
|
|
Vancomycin (Vancocin) MoA
|
Binds to D-alanyl-D-alanine portion of the cell wall precursors and prevents polymerization of peptidoglycans
|
|
|
|
Vancomycin (Vanconin) side effect
|
Red man syndrome:
flushing and pruritis of torso, neck, and face when used too rapidly |
|
|
|
Bacitracin
|
Inhibits cell wall synthesis by blocking the transport of peptidoglycan precursors across the cell membrane
Too toxic to use systemically Only used topically |
|
|
|
Vancomycin resistance
|
Amino acid change of D-ala D-ala to D-ala D-lac
|
|
|
|
Rash in smallpox
|
1) Macular to vesicular and pustular
2) 1-2 week course 3) First appears on face, in mouth, and on arms before spreading to the rest of the body 4) Some have bleeding into vesicles (hemorrhagic smallpox) |
|
|
|
DNA viruses families
|
Hepadnavirus: HBV
Herpesvirus: HSV-1, HSV-2, VZV, EBV, CMV, HHV-6, HHV-8 Adenovirus: (febrile pharyngitis, pneumonia, conjuctivitis) Parvovirus: B19 virus Papovavirus: HPV, JC Poxvirus: Smallpox, Molluscum contagiosum |
|
|
|
Double enveloped viruses
|
Herpes
HBV Smallpox |
|
|
|
Osteomyelitis
Causative agents: Most people: Sexually active: Diabetics and drug addicts: Sickle cell: Prosthetic replacement: Vertebral: |
Most people: S. aureus
Sexually active: N. gonorrhoeae Diabetics and drug addicts: P. aeruginosa Sickle cell: Salmonella Prosthetic replacement: S. aureus and S. epidermidis Vertebral: Mycobacterium tuberculosis (Pott's disease) |
|
|
|
Salmonella enterocolitis treatment
|
Supportive treatment only, if there is no systemic sequelae like osteomyelitis or meningitis
|
|
|
|
Gram -
Rods Lactose nonfermenter Oxidase - |
Shigella
Salmonella Proteus |
|
|
|
Gram -
Rods Lactose nonfermenters Oxidase + |
Pseudomonas
|
|
|
|
Gram -
Rods Lactose fermenters Fast fermenters |
Klebsiella
E. coli Enterobacter |
|
|
|
Gram -
Rods Lactose fermenters Slow fermenters |
Citrobacter
Serratia Others |
|
|
|
Chaga's disease treatment
|
Nifurtimox
Benznidazole |
|
|
|
Causes of eosinophilia
|
NAACP:
Neoplastic Asthma Allergic processes Collagen vascular disease Parasites |
|
|
|
RBC appearance in beta-thalassemia
|
Hypochromic microcytic anemia
Target cell Tear-drop shaped |
|
|
|
Hair on end skull on radiograpph
|
Beta-thalassemia
|
|
|
|
Cat scratch disease
Organism |
Baronella henselae
|
|
|
|
Small pleomorphic
Gram - bacilli Warthin-Starry stain positive Granulomatous inflammation with stellate necrosis in lymph nodes |
Bartonella henselae
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Aspergillosis laboratory technique?
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Silver stain
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Babesiosis laboratory tech?
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Giemsa blood smear
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Cat scratch disease lab tech?
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Warthin-Starry stain
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Cryptococcus lab tech?
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Sabouraud's medium or Niger seed agar
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Gonorrhea lab tech?
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Thayer-Martin media culture
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Legionnaire's disease lab tech?
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Charcoal yeast extract with silver stain
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Leprosy lab tech?
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Modified Fite-Franco stain (also acid fast)
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Lyme lab tech?
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Darkfield technique
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Ribaviring clinical use
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RSV
Chronic hepatitis C |
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Beta-hemolytic bacteria
Organisms? |
S. aureus (catalase + and coagulase +)
S. pyogenes (catalase - and bacitracin sensitive) S. agalactiae (catalase - and bacitracin resistant) L. monocytogenes (tumbling motility, meningitis in newborns, unpasteurized milk) |
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Gram +
Bacilli Non-spore forming Tumbling motility |
L. monocytogenes
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Only gram + with endotoxin
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Listeria
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Intracellular bugs:
Obligate intracellular |
Rickettsia
Chlamydia *can't make own ATP |
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Intracellular bugs:
Facultative intracellular |
Salmonella
Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia |
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Trifluridine (Viroptic)
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Thymidine analog
Phosphorylated by both cellular and viral thymidine kinases The triphosphate derivative is incorporated into viral and to a lesser extent mammalian DNA |
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Theophylline (Theo-Dur, Slo-bid)
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Methylxanthine prototypical
Phosphodiesterase inhibitor Blocks adenosine rcptrs Results in incr cAMP levels --> Bronchodilation and tachycardia |
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What's the treatment of choice for most rickettsial infections
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Tetracycline
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Ehrlichiosis:
Intracellular infection of monocytes. What agent? Intracellular infection of granulocytes |
Monocytes: Ehrlichia chaffeensis (HME)
Granulocytes: Ehrlichia phagocytophilia (HGE) |
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Rickettsial diseases and vectors:
Rocky mountain spotted fever Endemic typhus Epidemic typhus Q fever |
RMSF: tick__Rickettsia ricketsii
Endemic typhus: fleas__R. typhi Epidemic typhus: human body louse__R. prowazekii Q fever (no vector...inhaled aerosols): Coxiella burnetii |
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Diseases transmitted by Ixodes tick
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Lyme
Ehrlichiosis Bartonella Babesiosis |
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Parasites enter RBC
Ring-like structure in RBCs on Giemsa blood smear Sometimes tetrad daughter organisms are seen inside RBCs owing to asexual reproduction |
Babesiosis
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Babesiosis treatment
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Oral Malarone and azithromycin for 30 days
Mepron (atovaquone) and azithromycin for 30 days |
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What's the most appropriate diagnostic tool to demonstrate gallbladder stones?
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Real-time ultrasonography
98% sensitivity 95% specificity |
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How do gallstones form?
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Form when solubulizing bile acid and lecithin are overwhelmed by high cholesterol and/or bilirubin
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Causes of acute pancreatitis?
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EtOH
Gallstones |
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Guarnieri's bodies
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Smallpox
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What arteries anastomose if occlusion of the celiac artery occurs?
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Pancreaticoduodenal branches of both the superior mesenteric and gastroduodenal arteries
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What is the name of the space between the stomach, hepatoduodenal ligament, and hepatogastric ligament?
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Omental bursa
Can be entered through the epiploic foramen of Winslow |
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Portacaval anastomoses:
Sites of anastomoses Clinical signs |
1) Left gastric --> azygous (esophageal varices)
2) Superior --> inferior rectal (internal hemorrhoids) 3) Paraumbilical --> inferior epigastric ( caput medusae) 4) Retroperitoneal --> renal 5) Retroperitoneal --> paravertebral |
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Gallstones appearance:
Cholesterol Bilirubin Mixed |
Cholesterol: yellow, radiolucent
Bilirubin: pigmented, small, black, multiple, and radiolucent, hemolytic disease Mixed: chronic cholecystitis, cholesterol and calcium bilirubinate |
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"Fibrates"
Agents Lipid profile Side effects |
Gemfibrozil, clofibrate, bezafibrate, fenofibrate
Lower LDL, Increase HDL, Decrease triglycerides Myositis Increase LFTs Gallstones |
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Causes of hypercalcemia
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CHIPANZEES
Calcium ingestion (milk-alkali syndrome) Hyperthyroid Hyperparathyroid Iatrogenic (thiazides) Multiple myeloma Paget's disease Addison's disease Zollinger-Ellison syndrome Excess vit. D Excess vit. A Sarcoidosis |
CHIPANZEES
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Stellate giant-cell cytoplasmic inclusions (bodies)
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Asteroid bodies (not specific) found in sarcoidosis
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Laminated calcifications found in sarcoidosis (bodies)
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Schaumann bodies
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Anitschkow cells
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Large histiocytes found in aschoff bodies
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Aschoff bodies
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Focal collections of perivascular fibrinoid necrosis surrounded by inflammatory cells including large histiocytes (Anitschkow cells)
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Paget's cells
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Individual adenocarcinoma cells found within the squamous epithelium of the skin
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Grocott silver stain use
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Used to identify fungal organisms
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Naproxen MoA
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NSAID
Inhibits cyclooxygenase |
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Coarctation of the arota:
Associated conditions |
1) Turner's
2) Congenital bicuspid valve 3) Gonodal dysgenesis 4) Cerebral aneurysms 5) Infective endocarditis 6) Cerebral hemorrhage 7) Early arteriosclerosis |
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Acyanotic congenital heart defects
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No communication between circulations
1) Right-sided aorta 2) Ebstein's anomaly 3) Coarctation of the aorta 4) Tricuspid atresia |
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Cyanotic congenital heart defects
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Permanent right-to-left shunt
1) Tetralogy of Fallot 2) Truncus arteriosus 3) Transposition of the great vessels |
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Cyanose tardive congenital heart defects
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Initially left-to-right shunt then right-to-left shunt of Eisenmenger's
1) VSD 2) ASD 3) PDA 4) Persistent truncus arteriosus 5) Anomalous pulmonary venous drainage |
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Eisenmenger's syndrome
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Cyanosis
Clubbing Pulmonary HTN Heart failure Thickening of pulmonary artery walls |
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VSD
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Infective endocarditis
Failure to thrive Paradoxical emboli |
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ASD
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Early fatigability
Dyspnea of exertion Paradoxical emboli |
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Truncus arteriosus
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Heart failure
Recurrent pulmonary infections |
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Cyanotic shunts at birth
Causes |
5 T's
1) Truncus arteriosus 2) Transposition of great vessels 3) Tetralogy of Fallot 4) Tricuspid atresia 5) Total anomalous pulmonary venous congestion |
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Most common type of VSD defect
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Defect in the membranous septum (usually superior part)
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Most common type of ASD defect
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Ostium secundum
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Classic triad predisposing to DVT
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1) Endothelial injury
2) Stasis 3) Hypercoagulable state |
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QRS appearance in ventricular arrhythmia
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Widened
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Class 1B sodium channels blockers
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Lidocaine/Mexiletine/Tocainide
Depress the action potential Stabilize the cell membrane |
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Class 1B sodium channel blockers use
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Acute ventricular arrhythmias
Digitalis-induced arrhythmias |
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Class 1C sodium channel blockers
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Flecainide/Encainide/Propafenone
Depress action potential at phase 0 Stabilize cell membranes |
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Rb gene function
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Tumor suppressor gene inhibit cell proliferation
Rb protein binds to and sequesters the specific transcription factor E2F, inactivating E2F |
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E2F
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Increases transcription of a variety of proteins that move the cell from G1 to S phase of the cell cycle
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Proteins that promote cell cycle progression and cell proliferation are cellular?
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Oncogenes
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Ewing sarcoma
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1) Adolescents and young adults
2) Long limbs 3) Malignant neoplasm 4) Small blue cell tumors 5) Aggressive course |
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Small blue cell tumors
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1) Ewing sarcoma
2) Small cell carcinoma of the lung 3) Lymphoma 4) Neuroblastoma |
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3 types of ovarian tumors that produce high level of steroid hormone
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1) Sertoli-Leydig cell tumors
2) Fibroma-thecomas 3) Granulosa cell tumors |
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