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1437 Cards in this Set
- Front
- Back
often precedes squamous cell carcinoma
|
actinic keratosis
|
|
primary adrenocortical deficiency
|
Addison's disease
|
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polyostotic fibrous dysplasia, precocious puberty, cafe-au-lait spots, short stature, young girls - diagnosis?
|
Albright's syndrome
|
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hereditary nephritis with nerve deafness
|
Alport's syndrome
|
|
anti-basement membrane antibodies - diagnosis?
|
Goodpasture's syndrome
|
|
anticentromere antibodies - diagnosis?
|
scleroderma (CREST)
|
|
anti-double-stranded DNA antibodies (ANA antibodies) - diagnosis?
- what hypersensitivity type? |
SLE - type III hypersensitivity
|
|
anti-epithelial cell antibodies - diagnosis?
|
pemphigus vulgaris
|
|
antigliadin antibodies - diagnosis?
|
celiac disease
|
|
antihistone antibodies - diagnosis?
|
drug-induced SLE
|
|
anti-IgG antibodies - diagnosis?
|
rheumatoid arthritis
|
|
antimitochondrial antibodies - diagnosis?
|
primary biliary cirrhosis
|
|
antineutrophil antibodies - diagnosis?
|
vasculitis
|
|
antiplatelet antibodies - diagnosis?
|
idiopathic thrombocytopenic purpura
|
|
arachnodactyly - diagnosis?
|
Marfan's syndrome
|
|
Argyll-Robertson pupil - diagnosis?
|
neurosyphilis
|
|
Arnold-Chiari malformation
|
cerebellar tonsillar herniation
|
|
Aschoff bodies - diagnosis?
|
rheumatic fever
|
|
atrophy of the mammillary bodies - diagnosis?
|
Wernicke's encephalopathy
|
|
Auer rods - diagnosis?
|
acute myelogenous leukemia (especially promyelocytic type)
|
|
autosplenectomy - diagnosis?
|
sickle cell anemia
|
|
Babinski's sign is associated with what?
|
UMN lesion
|
|
"bamboo spine" on x-ray
|
ankylosing spondylitis
|
|
basophilic stippling of RBCs - diagnosis?
|
lead poisoning
|
|
defective dystrophin, less severe than Duchenne's
|
Becker's muscular dystrophy
|
|
LMN CN VII palsy
|
Bell's palsy
|
|
Bence Jones proteins - possible diagnoses?
- in each case, what are the proteins? |
multiple myeloma - kappa or lambda light chains
Waldenstrom's macroglobulinemia - IgM |
|
IgA nephropathy - diagnosis?
|
Berger's disease
|
|
Bernard-Soulier disease - what is the defect?
|
defect in platelet adhesion
|
|
bilateral hilar adenopathy, uveitis - diagnosis?
|
sarcoidosis
|
|
Birbeck granules on EM - diagnosis?
|
histiocytosis X (eosinophilic granuloma)
|
|
bloody tap on LP - diagnosis?
|
subarachnoid hemorrhage
|
|
"blue bloater"
|
chronic bronchitis
|
|
blue-domed cysts - diagnosis?
|
fibrocystic change of the breast
|
|
blue sclera - diagnosis?
|
osteogenesis imperfecta
|
|
boot-shaped heart on x-ray - possible diagnoses?
|
tetralogy of Fallot or RVH
|
|
Bouchard's nodes - diagnosis?
- where are they located? - why do they occur? |
osteoarthritis - on PIP secondary to osteophytes
|
|
boutonniere deformity - diagnosis?
|
rheumatoid arthritis
|
|
branching rods in oral infection - diagnosis?
|
Actinomyces israelii
|
|
"brown tumor" of bone - possible diagnoses?
- what causes the brown color? |
hyperparathyroidism or osteitis fibrosa cystica (von Recklinghausen's disease)
- color is due to hemorrhage in cysts |
|
X-linked agammaglobulinemia
|
Bruton's disease
|
|
posthepatic venous thrombosis - diagnosis?
|
Budd-Chiari syndrome
|
|
Buerger's disease - what size arteries does it affect?
|
small or medium-artery vasculitis
|
|
Burkitt's lymphoma - what is the translocation?
- what virus is it associated with? - appearance on histology? |
8:14 translocation
EBV starry sky appearance |
|
Burton's lines - diagnosis?
|
lead poisoning
|
|
what types of ANCA are associated with Wegener's granulomatosis and microscopic polyangiitis?
|
Wegener's - c-ANCA
MPA - p-ANCA |
|
cafe-au-lait spots on skin - diagnosis?
|
neurofibromatosis
|
|
calf pseudohypertrophy - diagnosis?
|
Duchenne's muscular dystrophy
|
|
Call-Exner bodies - diagnosis?
|
granulosa-theca cell tumor of the ovary
|
|
cardiomegaly with apical atrophy - diagnosis?
|
Chagas' disease
|
|
trypanosome infection - diagnosis?
|
Chagas' disease
|
|
painless chancre - diagnosis?
|
primary syphilis
|
|
painful chancroid - cause?
|
Haemophilus ducreyi
|
|
Charcot's triad of multiple sclerosis
|
nystagmus, intention tremor, scanning speech
|
|
Charcot's triad of cholangitis
|
jaundice, RUQ pain, fever
|
|
Charcot-Leyden crystals - diagnosis?
- what are they? |
bronchial asthma - eosinophil membranes
|
|
what is the defect in Chediak-Higashi disease?
|
phagocyte deficiency
|
|
cherry-red spot on macula - possible diagnoses?
|
Tay-Sachs or Niemann-Pick disease
|
|
what are Cheyne-Stokes respirations, and in what circumstance do they occur?
|
central apnea in CHF and increased intracranial pressure
|
|
"chocolate cysts"
|
endometriosis
|
|
what does chronic atrophic gastritis predispose to?
|
gastric carcinoma
|
|
Chvostek's sign - what is it, and what does it indicate?
|
facial muscle spasm upon tapping - sign of hypocalcemia
|
|
DES exposure in utero predisposes to what?
|
clear cell adenocarcinoma of the vagina
|
|
clue cells - diagnosis?
|
Gardnerella vaginitis
|
|
Codman's triangle on x-ray - diagnosis?
|
osteosarcoma
|
|
cold agglutinins - possible diagnoses?
|
Mycoplasma pneumonia or infectious mononucleosis
|
|
cold intolerance - sign of what?
|
hypothyroidism
|
|
condylomata lata - diagnosis?
|
secondary syphilis
|
|
continuous machinery murmur - indicates what?
|
patent ductus arteriosus
|
|
what is the defect in Cori's disease?
|
debranching enzyme deficiency
|
|
cough, conjunctivitis, coryza, fever - diagnosis?
|
measles
|
|
Councilman bodies - diagnosis?
|
toxic or viral hepatitis
|
|
Cowdry type A bodies - caused by what?
|
herpesvirus
|
|
crescents in Bowman's capsule - diagnosis?
|
rapidly progressive crescentic glomerulonephritis
|
|
what is Crigler-Najjar syndrome?
|
congenital unconjugated hyperbilirubinemia - due to absent UDP glucuronyl transferase
|
|
acute gastric ulcer associated with severe burns
|
Curling's ulcer
|
|
currant-jelly sputum - diagnosis?
|
Klebsiella
|
|
Curschmann's spirals - diagnosis?
- what are they? |
bronchial asthma - whorled mucous plugs
|
|
acute gastric ulcer associated with CNS injury
|
Cushing's ulcer
|
|
D-dimers - diagnosis?
|
DIC
|
|
depigmentation of neurons in substantia nigra - diagnosis?
- where is the defect? - symptoms? |
Parkinson's disease - basal ganglia disorder
- rigidity, resting tremor, bradykinesia |
|
dermatitis, dementia, diarrhea - diagnosis?
|
pellagra (niacin/vitamin B3 deficiency)
|
|
dog or cat bite - infected with?
|
Pasteurella multocida
|
|
what is Dressler's syndrome?
|
post-MI fibrinous pericarditis
|
|
what is Dubin-Johnson syndrome?
- what is the defect? - what is the pathologic consequence? |
congenital conjugated hyperbilirubinemia - due to defective liver excretion of conjugated bilirubin, causing black liver
|
|
what is the defect in Duchenne's muscular dystrophy?
- what is the inheritance pattern? |
deleted dystrophin gene - X-linked recessive
|
|
eburnation - diagnosis?
|
osteoarthritis
|
|
trisomy 18 associated with rocker-bottom feet, low-set ears, heart disease
|
Edwards' syndrome
|
|
what is Eisenmenger's complex?
|
late cyanosis shunt (reversal of an uncorrected L-R shunt to an R-L shunt)
|
|
elastic skin - diagnosis?
|
Ehlers-Danlos syndrome
|
|
where and what is Erb-Duchenne palsy?
|
superior trunk injury to brachial plexus (C5-6) - "waiter's tip"
|
|
erythema chronicum migrans - diagnosis?
|
Lyme disease
|
|
genetically inherited aplastic anemia
|
Fanconi's anemia
|
|
what is Fanconi's syndrome?
|
proximal tubular reabsorption defect (causes excretion of many things - leads to, among other things, rickets, metabolic acidosis, hypokalemia)
|
|
"fat, female, forty, and fertile" - at risk for?
|
acute cholecystitis
|
|
fatty liver - associated with?
|
alcoholism
|
|
ferruginous bodies - diagnosis?
|
asbestosis
|
|
colon polyps with osteomas and soft tissue tumors - diagnosis?
|
Gardner's syndrome
|
|
what is the defect in Gaucher's disease?
|
glucocerebrosidase deficiency
|
|
Ghon focus - diagnosis?
|
primary TB
|
|
what is Gilbert's syndrome?
- what is the deficiency? |
benign congenital unconjugated hyperbilirubinemia - due to mildly decreased UDP-glucouronyl transferase or decreased bilirubin uptake by liver
|
|
what is the defect in Glanzmann's thrombasthenia?
|
defect in platelet aggregation (defect in GPIIb/IIIa)
|
|
autoantibodies against alveolar and glomerular basement membrane proteins - diagnosis?
|
Goodpasture's syndrome
|
|
Gowers' maneuver - diagnosis?
- what is the maneuver? |
Duchenne's - use of patient's arms to help legs pick self off floor
|
|
idiopathic peripheral polyneuritis - diagnosis?
|
Guillain-Barre syndrome
|
|
"hair on end" (crew cut) appearance on x-ray - possible diagnoses?
- why does this happen? |
beta-thalassemia or sickle cell anemia - due to extramedullary hematopoiesis
|
|
what is Hand-Schuller-Christian disease?
|
chronic progressive histiocytosis (Langerhans cell histiocytosis)
|
|
lots of HbF - diagnosis?
|
thalassemia major
|
|
HbS - diagnosis?
|
sickle cell anemia
|
|
conditions in which hCG is elevated
|
choriocarcinoma, hydatidiform mole
|
|
Heberden's nodes - diagnosis?
- where are they located? - why do they occur? |
osteoarthritis - DIP swelling secondary to osteophytes
|
|
Heinz bodies - diagnosis?
|
G6PD deficiency
|
|
hypersensitivity vasculitis associated with hemorrhagic urticaria and upper respiratory tract infections - diagnosis?
|
Henoch-Schonlein purpura
|
|
heterophil antibodies - diagnosis?
- caused by what? |
infectious mononucleosis - caused by EBV
|
|
high-output cardiac failure (dilated cardiomyopathy) is associated with what vitamin deficiency?
- what is the disease called? |
vitamin B1 (thiamine) deficiency - wet beriberi
|
|
HLA-B27 - associated with what diseases?
|
Reiter's syndrome, ankylosing spondylitis, psoriasis, inflammatory bowel disease
|
|
disease associated with HLA-DR3 or DR4
- what causes it? |
diabetes mellitus type 1 - autoimmune destruction of beta cells
|
|
Homer Wright rosettes - diagnosis?
|
neuroblastoma
|
|
honeycomb lung on x-ray - diagnosis?
|
interstitial fibrosis
|
|
symptoms of Horner's syndrome
|
ptosis, miosis, anhidrosis
|
|
Howell-Jolly bodies - caused by what?
|
splenectomy or nonfunctional spleen
|
|
caudate degeneration - diagnosis?
- what is the inheritance pattern? |
Huntington's disease - autosomal dominant
|
|
hyperphagia, hypersexuality, hyperorality, hyperdocility - diagnosis?
- what is the affected organ? |
Kluver-Bucy syndrome - affects amygdala
|
|
hyperpigmentation of skin - diagnosis?
|
primary adrenal insufficiency (Addison's disease)
|
|
hypersegmented neutrophils - diagnosis?
|
macrocytic anemia
|
|
hypertension and hypokalemia - diagnosis?
|
Conn's syndrome (aldosterone-secreting tumor)
|
|
hypochromic microcytosis - possible diagnoses?
|
iron deficiency anemia, lead poisoning
|
|
increased alpha-fetoprotein in amniotic fluid/maternal serum - possible diagnoses?
|
neural tube defects (anencephaly, spina bifida)
|
|
increased uric acid levels - possible diagnoses?
|
gout, Lesch-Nyhan syndrome, myeloproliferative disorders, use of loop and thiazide diuretics
|
|
Janeway lesions - diagnosis?
|
endocarditis
|
|
what disease is the Jarish-Herxheimer reaction associated with, and what is it?
|
syphilis - overaggressive treatment of an asymptomatic patient that causes symptoms due to rapid lysis
|
|
what is the defect in Job's syndrome?
|
neutrophil chemotaxis abnormality - due to failure of IFN-gamma production by helper T cells
|
|
Kaposi's sarcoma - associated with?
|
AIDS in MSM
|
|
what is the defect in Kartagener's syndrome?
|
dynein defect
|
|
Kayser-Fleischer rings - diagnosis?
|
Wilson's disease
|
|
keratin pearls - diagnosis?
|
squamous cell carcinoma
|
|
Kimmelstiel-Wilson nodules - diagnosis?
|
diabetic nephropathy
|
|
bilateral amygdala lesions - diagnosis?
|
Kluver-Bucy syndrome
|
|
koilocytes - diagnosis?
|
HPV
|
|
Koplik spots - diagnosis?
|
measles
|
|
gastric adenocarcinoma with ovarian metastases
|
Krukenberg tumor (Puneet, this one is for you)
|
|
Kussmaul hyperpnea - diagnosis?
|
diabetic ketoacidosis
|
|
lens dislocation, aortic dissection, joint hyperflexibility - diagnosis?
- what is the defect? |
Marfan's syndrome - defect in fibrillin
|
|
what is the defect in Lesch-Nyhan syndrome?
|
HGPRT deficiency
|
|
Lewy bodies - diagnosis?
|
Parkinson's disease
|
|
what is Libman-Sacks disease?
|
endocarditis associated with SLE
|
|
lines of Zahn - diagnosis?
|
arterial thrombus
|
|
Lisch nodules - diagnosis?
|
neurofibromatosis (von Recklinghausen's disease)
|
|
low serum ceruloplasmin - diagnosis?
|
Wilson's disease
|
|
lucid interval - associated with what head pathology?
|
epidural hematoma
|
|
"lumpy-bumpy" appearance of glomeruli on immunofluorescence - diagnosis?
|
poststreptococcal glomerulonephritis
|
|
lytic bone lesions on x-ray - diagnosis?
|
multiple myeloma
|
|
Mallory bodies - diagnosis?
|
alcoholic liver disease
|
|
esophagogastric lacerations - diagnosis?
|
Mallory-Weiss syndrome
|
|
what is the defect in McArdle's disease?
|
muscle phosphorylase deficiency
|
|
McBurney's sign - diagnosis?
|
appendicitis
|
|
MLF syndrome (internuclear ophthalmoplegia) - diagnosis?
|
multiple sclerosis
|
|
monoclonal antibody spike - possible diagnoses?
- what makes up the spike in each? |
multiple myeloma (IgG or IgA)
MGUS Waldenstrom's macroglobulinemia (IgM) |
|
myxedema - diagnosis?
|
hypothyroidism
|
|
necrotizing vasculitis of the lungs (hemoptysis) and necrotizing glomerulonephritis - possible diagnoses?
|
Wegener's or Goodpasture's
|
|
needle-shaped, negatively birefringent crystals - diagnosis?
|
gout
|
|
Negri bodies - diagnosis?
|
rabies
|
|
nephritis, cataracts, hearing loss - diagnosis?
- what is the defect? |
Alport's syndrome
- type IV collagen defect |
|
neurofibrillary tangles - diagnosis?
|
Alzheimer's disease
|
|
what is the defect in Niemann-Pick disease?
|
sphingomyelinase deficiency
|
|
no lactation postpartum - diagnosis?
- what causes it? |
Sheehan's syndrome - due to pituitary infarction
|
|
nutmeg liver - diagnosis?
|
CHF
|
|
occupational exposure to asbestos - associated with?
|
malignant mesothelioma
|
|
"Orphan Annie" nuclei - diagnosis?
|
papillary carcinoma of the thyroid
|
|
Osler's nodes - diagnosis?
|
endocarditis
|
|
owl's eye inclusion bodies - diagnosis?
|
CMV
|
|
eczematous dermatitis of nipple or areola - diagnosis?
- what is it a sign of? |
Paget's disease of breast
- sign of underlying neoplasm |
|
increased osteoblastic and osteoclastic activity - diagnosis?
|
Paget's disease of bone (osteitis deformans)
|
|
painless jaundice - diagnosis?
|
pancreatic cancer (of head)
|
|
palpable purpura on legs and buttocks - diagnosis?
|
Henoch-Schonlein purpura
|
|
bronchogenic apical tumor associated with Horner's syndrome
|
Pancoast's tumor
|
|
pannus - diagnosis?
|
rheumatoid arthritis
|
|
nigrostriatal dopamine depletion - diagnosis?
|
Parkinson's disease
|
|
periosteal elevation on x-ray - diagnosis?
|
pyogenic osteomyelitis
|
|
benign polyposis - diagnosis?
|
Peutz-Jeghers syndrome
|
|
penile fibrosis - diagnosis?
|
Peyronie's disease
|
|
Philadelphia chromosome (bcr-abl) - diagnosis?
|
CML
|
|
Pick bodies - diagnosis?
|
Pick's disease
|
|
progressive dementia, similar to Alzheimer's - diagnosis?
|
Pick's disease
|
|
"pink puffer" - diagnosis?
- what are the two types, and what causes them? |
emphysema
- centroacinar - due to smoking - panacinar - due to alpha1-antitrypsin deficiency |
|
esophageal webs with iron deficiency anemia - diagnosis?
|
Plummer-Vinson syndrome
|
|
podagra - diagnosis?
- where is it located? |
gout - MP joint of hallux
|
|
podocyte fusion - diagnosis?
|
minimal change disease
|
|
polyneuropathy, cardiac pathology, and edema - diagnosis?
- what causes it? |
wet beriberi (vitamin B1 deficiency)
|
|
polyneuropathy preceded by GI or respiratory infection
|
Guillain-Barre syndrome
|
|
what is the defect in Pompe's disease?
- what significant finding is it associated with? |
lysosomal glucosidase deficiency
- cardiomegaly |
|
port-wine stain - diagnosis?
|
hemangioma
|
|
positive anterior "drawer sign" - diagnosis?
|
anterior cruciate ligament injury
|
|
what is Pott's disease?
|
vertebral tuberculosis
|
|
pseudopalisade tumor cell arrangement - diagnosis?
|
glioblastoma multiforme
|
|
pseudorosettes - diagnosis?
|
Ewing's sarcoma
|
|
ptosis, miosis, anhidroisis - diagnosis?
- often associated with what? |
Horner's syndrome
- Pancoast's tumor |
|
rash on palms and soles - possible diagnoses?
|
secondary syphilis, Rocky Mountain Spotted Fever, coxsackie A virus
|
|
recurrent vasospasm in extremities - diagnosis?
|
Raynaud's syndrome
|
|
RBC casts in urine - diagnosis?
|
acute glomerulonephritis
|
|
recurrent pulmonary Pseudomonas and S. aureus infections - associated with?
|
cystic fibrosis
|
|
red urine in the morning - diagnosis?
|
paroxysmal nocturnal hemoglobinuria
|
|
Reed-Sternberg cells - diagnosis?
|
Hodgkin's lymphoma
|
|
increased Reid index - diagnosis?
|
chronic bronchitis (gland depth/total thickness of bronchial wall)
|
|
Reinke crystals - diagnosis?
|
Leydig cell tumor
|
|
what are the symptoms of Reiter's syndrome?
|
urethritis, conjunctivitis, arthritis
|
|
renal cell carcinoma, cavernous hemangiomas, adenomas - diagnosis?
|
von Hippel-Lindau disease
|
|
renal epithelial casts in urine - diagnosis?
|
acute toxic/viral nephrosis
|
|
rhomboid crystals, positively birefringent - diagnosis?
|
pseudogout
|
|
rib notching - diagnosis?
|
coarctation of aorta
|
|
Roth's spots in retina - diagnosis?
|
endocarditis
|
|
what is Rotor's syndrome?
- what is the defect? - similar to what disease? |
congenital conjugated hyperbilirubinemia
- defective liver excretion of bilirubin (similar to Dubin-Johnson, but milder) |
|
rouleaux formation of RBCs - diagnosis?
|
multiple myeloma
|
|
S3 - possible diagnoses?
|
left-to-right shunt (VSD, PDA, ASD), mitral regurgitation, CHF (LV failure)
|
|
S4 - possible diagnoses?
|
aortic stenosis, hypertrophic subaortic stenosis
|
|
Schiller-Duval bodies - diagnosis?
|
yolk sac tumor
|
|
senile plaques - diagnosis?
|
Alzheimer's disease
|
|
what is Sezary syndrome?
|
cutaneous T-cell lymphoma
|
|
what is Sheehan's syndrome?
|
postpartum pituitary necrosis
|
|
Schwartzman reaction - associated with?
|
Neisseria meningitidis
|
|
signet-ring cells - diagnosis?
|
gastric carcinoma
|
|
simian crease - diagnosis?
|
Down syndrome
|
|
Sipple's syndrome - also known as?
|
MEN IIa
|
|
dry eyes, dry mouth, arthritis - diagnosis?
|
Sjogren's syndrome
|
|
skip lesions - diagnosis?
|
Crohn's
|
|
slapped cheeks - diagnosis?
|
erythema infectiosum (fifth disease)
|
|
Smith antigen - diagnosis?
|
SLE
|
|
"smudge cell" - diagnosis?
|
CLL
|
|
soap bubble on x-ray - diagnosis?
|
giant cell tumor of bone
|
|
spike and dome on EM - diagnosis?
|
membranous glomerulonephritis
|
|
what is a Spitz nevus?
|
benign juvenile melanoma
|
|
splinter hemorrhages in fingernails - diagnosis?
|
endocarditis
|
|
starry-sky pattern - diagnosis?
|
Burkitt's lymphoma
|
|
"strawberry tongue" - diagnosis?
|
scarlet fever
|
|
streaky ovaries - diagnosis?
|
Turner's syndrome
|
|
string sign on x-ray - diagnosis?
|
Crohn's disease
|
|
subepithelial humps on EM - diagnosis?
|
poststreptococcal glomerulonephritis
|
|
suboccipital lymphadenopathy - diagnosis?
|
rubella
|
|
sulfur granules - diagnosis?
|
Actinomyces israelii
|
|
swollen gums, bruising, poor wound healing, anemia - diagnosis?
- what is this due to? - why do these symptoms occur? |
scury - vitamin C (ascorbic acid) deficiency
- vitamin C is needed for hydroxylation of proline and lysine in collagen synthesis |
|
systolic ejection murmur (crescendo-decrescendo) - diagnosis?
|
aortic valve stenosis
|
|
t(8;14) - diagnosis?
- gene involved? |
Burkitt's lymphoma
- c-myc activation |
|
t(9;22) - diagnosis?
- gene involved? |
CML
- Philadelphia chromosome - bcr-abl hybrid |
|
t(14;18) - diagnosis?
- gene involved? |
follicular lymphoma
- bcl-2 activation |
|
tabes dorsalis - diagnosis?
|
tertiary syphilis
|
|
tendon xanthomas (classically Achilles) - diagnosis?
|
familial hypercholesterolemia
|
|
thumb sign on lateral x-ray - diagnosis?
- caused by what? |
epiglottitis - due to Haemophilus influenzae
|
|
thyroidization of kidney - diagnosis?
|
chronic bacterial pyelonephritis
|
|
tophi - diagnosis?
|
gout
|
|
"tram-track" appearance on LM - diagnosis?
|
membranoproliferative glomerulonephritis
|
|
what is Trousseau's sign of malignancy?
- possible diagnoses? |
migratory thrombophlebitis
- visceral cancer or pancreatic adenocarcinoma |
|
what is Trousseau's sign of latent tetany?
- diagnosis? |
carpal spasm
- hypocalcemia |
|
what is Virchow's node?
- what is it a sign of? |
left supraclavicular node enlargement
- from metastatic carcinoma of the stomach |
|
what is Virchow's triad?
- predilection for what? |
blood stasis, endothelial damage, hypercoagulation
- pulmonary embolism |
|
neurofibromatosis with cafe-au-lait spots - diagnosis?
|
von Recklinghausen's disease
|
|
what is von Recklinghausen's disease of bone?
|
osteitis fibrosa cystica ("brown tumor")
|
|
adrenal hemorrhage associated with meningococcemia - diagnosis?
|
Waterhouse-Friderichsen syndrome
|
|
waxy casts in urine - diagnosis?
|
chronic end-stage renal disease
|
|
WBC casts in urine - diagnosis?
|
acute pyelonephritis
|
|
WBCs in urine - diagnosis?
|
acute cystitis
|
|
Wermer's syndrome - also known as?
|
MEN type I
|
|
what is Whipple's disease?
- caused by what? |
malabsorption syndrome caused by Tropheryma whippelii
|
|
hepatolenticular degeneration - diagnosis?
|
Wilson's disease
|
|
"wire loop" appearance on LM - diagnosis?
|
lupus nephropathy
|
|
"worst headache of my life" - rupture of what?
- associated with what syndrome? |
rupture of berry aneurysm
- associated with adult polycystic kidney disease |
|
xanthochromia of CSF - diagnosis?
|
subarachnoid hemorrhage
|
|
xerostomia, arthritis, keratoconjunctivitis sicca - diagnosis?
|
Sjogren's syndrome
|
|
upper GI diverticulum
|
Zenker's diverticulum
|
|
gastrin-secreting tumor associated with ulcers - diagnosis?
|
Zollinger-Ellison syndrome
|
|
most common bacteremia/pneumonia among IV drug abusers
|
S. aureus
|
|
most common bacteria associated with cancer
|
H. pylori
|
|
most common bacteria found in GI tract
- 2nd most common? |
Bacterioides
- E. coli |
|
4 most common brain tumors in adults
|
mets > astrocytoma (including glioblastoma multiforme) > meningioma > schwannoma
|
|
most common brain tumor in kids
- location? |
medulloblastoma - in cerebellum
|
|
most common supratentorial brain tumor in kids
|
craniopharyngioma
|
|
most common breast cancer
|
infiltrating ductal carcinoma
|
|
most common breast mass
- most common in post menopausal women? |
fibrocystic change
- carcinoma |
|
most common benign breast tumor
|
fibroadenoma
|
|
most common bug in debilitated, hospitalized pneumonia patient
|
Klebsiella
|
|
most common cardiac primary tumor in adults
- usual location and appearance? |
myxoma
- "ball and valve" in left atrium |
|
most common cardiac primary tumor in kids
|
rhabdomyoma
|
|
most common cardiac tumor in adults
|
mets
|
|
most common cardiomyopathy
|
dilated cardiomyopathy
|
|
most common chromosomal disorder
- what other disorders is it associated with? |
Down syndrome
- associated with ALL, Alzheimer's dementia, endocardial cushion defects |
|
most common chronic arrhythmia
- what is the patient at high risk for? |
atrial fibrillation - high risk of emboli
|
|
most common congenital cardiac anomaly
|
VSD
|
|
most common cause of constrictive pericarditis
|
tuberculosis
|
|
most common coronary arteries involved in thrombosis
|
LAD > RCA > LCA
|
|
most common causes of early cyanosis
|
tetralogy of Fallot, transposition of great vessels, truncus arteriosus
|
|
most common causes of late cyanosis
|
VSD, ASD, PDA
|
|
how do you close a PDA?
- how do you keep it open? |
close with indomethacin
open with misoprostol |
|
most common demyelinating disease
|
multiple sclerosis
|
|
most common dietary deficit
|
iron
|
|
most common cause of epiglottitis
|
Haemophilus influenzae type B
|
|
most common esophageal cancer
|
squamous cell carcinoma
|
|
most common gene involved in cancer
|
p53 tumor suppressor gene
|
|
most common group affected by cystic fibrosis
- what dietary deficiency is associated with CF? - what lung problems occur? |
Caucasians
- fat-soluble vitamin deficiencies - mucous plugs and lung infections |
|
most common gynecologic malignancy
|
endometrial carcinoma
|
|
most common heart murmur
|
mitral valve prolapse
|
|
most common heart valve involved in bacterial endocarditis
|
mitral
|
|
most common heart valve involved in bacterial endocarditis in IV drug abusers
|
tricuspid
|
|
most common heart valve involved in rheumatic fever
- which is 2nd most common? |
mitral valve
- aortic is 2nd |
|
most common helminth infection in the U.S.
- 2nd most common? |
Enterobius vermicularis
- Ascaris lumbricoides is 2nd most common |
|
most common hereditary bleeding disorder
|
von Willebrand's
|
|
most common kidney stone
- 2nd most common? - are they each radiopaque or radiolucent? - how are the 2nd most common formed? |
calcium - radiopaque
2nd is ammonium - radiopaque - formed by urease-positive organisms like Proteus vulgaris or Staphylococcus |
|
most common leukemia in adults
|
AML
|
|
most common liver disease
|
alcoholic liver disease
|
|
most common location of brain tumors in adults
|
supratentorial
|
|
most common location of brain tumors in kids
|
infratentorial
|
|
most common lysosomal storage disease
|
Gaucher's disease
|
|
most common male cancer
|
prostatic carcinoma
|
|
most common malignancy associated with noninfectious fever
|
Hodgkin's disease
|
|
most common malignant skin tumor
- does it metastasize? |
basal cell carcinoma
- only very rarely metastasizes |
|
most common mets to bone
|
breast, lung, thyroid, testes, prostate, kidney
|
|
most common mets to brain
|
lung, breast, skin (melanoma), kidney (renal cell carcinoma), GI
|
|
most common mets to liver
|
colon, gastric, pancreatic, breast, lung carcinomas
|
|
most common motor neuron disease
|
ALS
|
|
most common neoplasm in kids
- 2nd most common? |
ALL
- cerebellar medulloblastoma is 2nd |
|
most common nephrotic syndrome
|
membranous glomerulonephritis
|
|
most common obstruction of male urinary tract
|
BPH
|
|
most common opportunistic infection in AIDS
|
Pneumocystis jiroveci pneumonia
|
|
most common organ receiving mets
- why? |
adrenal glands
- rich blood supply |
|
most common organs sending mets
|
lung > breast, stomach
|
|
most common benign ovarian tumor
|
serous cystadenoma
|
|
most common malignant ovarian tumor
|
serous cystadenocarcinoma
|
|
most common pancreatic tumor
- which part of pancreas is affected? |
adenocarcinoma of the head of the pancreas
|
|
most common age of patient with ALL
|
child
|
|
most common age of patient with CLL
|
adult >60
|
|
most common age of patient with AML
|
adult >60
|
|
most common age of patient with CML
|
adult 35-50
|
|
most common patient with Hodgkin's
- exception: nodular sclerosis type - what patient? |
young male
- nodular sclerosis type - female |
|
most common patient with minimal change disease
|
young child
|
|
most common patient with Reiter's
|
male
|
|
most common pituitary tumor
- 2nd most common? how does it stain? |
prolactinoma
- somatotropic adenoma is 2nd - acidophilic |
|
most common preventable cancer
|
lung cancer
|
|
most common primary bone tumor in adults
|
multiple myeloma
|
|
most common cause of primary hyperparathyroidism
- other causes? |
adenomas
- also hyperplasia and carcinoma |
|
most common primary liver tumor
|
hepatoma
|
|
most common renal tumor
- what diseases is it associated with? - what paraneoplastic syndromes is it associated with? |
renal cell carcinoma
- von Hippel-Lindau and acquired polycystic kidney disease - erythropoietin, renin, PTH, ACTH |
|
most common cause of secondary hyperparathyroidism
|
hypocalcemia of chronic renal failure
|
|
most common sexually transmitted disease
|
Chlamydia
|
|
most common site of diverticula
|
sigmoid colon
|
|
most common site of metastasis
- 2nd most common? |
regional lymph nodes
- liver is 2nd |
|
most common sites of atherosclerosis
|
abdominal aorta > coronary > popliteal > carotid
|
|
most common skin cancer
|
basal cell carcinoma
|
|
most common stomach cancer
|
adenocarcinoma
|
|
most common testicular tumor
|
seminoma
|
|
most common thyroid cancer
|
papillary carcinoma
|
|
most common tumor in men
|
prostate carcinoma
|
|
most common tumor in women
|
leiomyoma (estrogen dependent)
|
|
most common tumor of infancy
|
hemangioma
|
|
most common tumor of the adrenal medulla in adults
- benign or malignant? |
pheochromocytoma - benign
|
|
most common tumor of the adrenal medulla in kids
- benign or malignant? |
neuroblastoma - malignant
|
|
most common type of Hodgkin's
|
nodular sclerosis
|
|
most common type of non-Hodgkin's
|
follicular (small cleaved)
|
|
most common type of pituitary adenoma
|
prolactinoma
|
|
most common vasculitis
- poses risk for? - what causes this? |
temporal arteritis
- risk of ipsilateral blindness - due to thrombosis of opthalmic artery |
|
most common cause of viral encephalitis
|
HSV
|
|
most common vitamin deficiency in the U.S.
- how long do body stores last? - what patient population is most at risk? |
folic acid - stores last 3-4 months
- pregnant women at high risk |
|
most common cause of Addison's
- 2nd most common? |
autoimmune
- infection is 2nd |
|
most common cause of dissecting aneurysm
|
hypertension
|
|
most common cause of descending and abdominal aortic aneurysm
|
atherosclerosis
|
|
most common cause of ascending aortic aneurysm
|
tertiary syphilis
|
|
most common cause of bacterial meningitis in adults
|
Streptococcus pneumoniae
|
|
most common cause of bacterial meningitis in the elderly
|
S. pneumoniae
|
|
most common cause of bacterial meningitis in kids
|
S. pneumoniae or Neisseria meningitidis
|
|
most common cause of bacterial meningitis in newborns
|
group B streptococcus
|
|
most common cancer associated with AIDS
|
Kaposi's sarcoma
|
|
most common cause of congenital adrenal hyperplasia
|
21-hydroxylase deficiency
|
|
most common cause of cretinism
|
iodine deficit/hypothyroidism
|
|
most common cause of Cushing's syndrome
- 2nd most common? |
corticosteroid therapy
- excess ACTH secretion by pituitary is 2nd |
|
most common cause of death in CML
|
blast crisis
|
|
most common cause of death in SLE
|
lupus nephropathy
|
|
most common cause of dementia
- 2nd most common? |
Alzheimer's
- multi-infarct is 2nd |
|
most common causes of DIC
|
Gram-negative sepsis, obstetric complications, cancer, burn trauma
|
|
most common cause of ejection click
|
aortic/pulmonic stenosis
|
|
most common cause of food poisoning
|
S. aureus
|
|
most common cause of glomerulonephritis in adults
|
IgA nephropathy (Berger's disease)
|
|
most common cause of epidural hematoma
- is bleeding fast or slow? |
rupture of middle meningeal artery - fast bleeding
|
|
most common cause of subdural hematoma
- is bleeding fast or slow? |
rupture of bridging veins due to trauma - slow bleeding
|
|
most common cause of hemochromatosis
- causes risk of? |
multiple blood transfusions
- can cause CHF and increased risk of hepatocellular carcinoma |
|
most common cause of hepatic cirrhosis
|
alcohol
|
|
most common cause of hepatocellular carcinoma
|
cirrhotic liver, often due to hepatitis B and C
|
|
most common causes of holosystolic murmur
|
VSD, tricuspid regurgitation, mitral regurgitation
|
|
most common cause of secondary hypertension
|
renal disease
|
|
most common cause of hypoparathyroidism
|
thyroidectomy
|
|
most common cause of hypopituitarism
|
adenoma
|
|
most common infection in blood transfusion
|
hepatitis C
|
|
most common infection in burn victims
|
Pseudomonas
|
|
most common cause of "machine-like" murmur
|
PDA
|
|
most common cause of mental retardation
- 2nd most common? |
Down syndrome
- fragile X is 2nd |
|
most common cause of MI
|
atherosclerosis
|
|
most common cause of mitral valve stenosis
|
rheumatic heart disease
|
|
most common cause of myocarditis
|
coxsackie B
|
|
most common cause of nephrotic syndrome in adults
|
membranous glomerulonephritis
|
|
most common cause of nephrotic syndrome in kids
- how do you treat it? |
minimal change disease
- treat with corticosteroids |
|
most common cause of opening snap
|
mitral stenosis
|
|
most common cause of osteomyelitis
|
S. aureus
|
|
most common cause of osteomyelitis in patients with sickle cell disease
|
Salmonella
|
|
most common cause of osteomyelitis in IV drug abusers
|
Pseudomonas
|
|
most common causes of acute pancreatitis
|
alcohol and gallstones
|
|
most common cause of chronic pancreatitis in adults
- in kids? |
alcohol in adults
cystic fibrosis in kids |
|
most common cause of peau d'orange
|
carcinoma of the breast
|
|
most common cause of PID
|
Neisseria gonorrhoeae
|
|
most common cause of hospital-acquired pneumonia
|
Klebsiella
|
|
most common cause of pneumonia in cystic fibrosis or burn infection
|
Pseudomonas aeruginosa
|
|
most common cause of preventable blindness
|
Chlamydia
|
|
most common cause of primary amenorrhea
- what is the abnormality? |
Turner's - XO
|
|
most common cause of primary hyperaldosteronism
|
adenoma of adrenal cortex
|
|
most common cause of primary hyperparathyroidism
|
adenoma
|
|
most common cause of pulmonary hypertension
|
COPD
|
|
most common cause of right heart failure due to a pulmonary cause
|
cor pulmonale
|
|
most common cause of right-sided heart failure
|
left-sided heart failure
|
|
most common cause of Sheehan's syndrome
|
postpartum pituitary infarction secondary to hemorrhage
|
|
most common cause of SIADH
|
small cell carcinoma of the lung
|
|
most common cause of UTI
|
E. coli
|
|
most common causes of UTI in young women
|
E. coli and Staphylococcus saprophyticus
|
|
heterochromatin vs. euchromatin
|
HeteroChromatin = Highly Condensed (transcriptionally inactive)
euchromatin = less condensed, transcriptionally active ("truly transcribed") |
|
what nucleotides are purines?
|
A,G (PURines = PURe As Gold)
|
|
what nucleotides are pyrimidines?
|
C,U,T (PYrimidines = CUT the PY)
|
|
what functional group does thymine have?
|
THYmine has a meTHYl
|
|
what amino acids are needed for purine synthesis?
|
Glycine, Aspartate, Glutamine (A and G are purines)
|
|
hydroxyurea - mechanism of action?
|
inhibits ribonucleotide reductase (converts ribonucleotides to deoxyribonucleotides)
|
|
6-mercaptopurine - mechanism of action?
|
blocks de novo purine synthesis
|
|
5-fluorouracil - mechanism of action?
|
inhibits thymidylate synthase (makes dTMP from dUMP)
|
|
mechanism of action of methotrexate and trimethoprim
|
inhibit dihydrofolate reductase (makes THF, which is needed for dTMP synthesis)
|
|
transition vs. transversion
|
transition - substituting purine for purine, e.g. (transItion = Identical type)
transversion - substituting purine for pyrimidine, e.g. (transVersion = conVersion between types) |
|
nonsense mutation
|
change resulting in an early stop codon (Stop the nonsense!)
|
|
fluoroquinolones - mechanism of action?
|
inhibit DNA gyrase
|
|
what is the defect in xeroderma pigmentosum?
|
mutated endonucleases (for nucleotide excision repair) - prevents repair of thymidine dimers
|
|
what is the defect in hereditary nonpolyposis colorectal cancer?
|
mutated mismatch repair genes
|
|
what are the 3 types of RNA, and what are their distinguishing characteristics?
|
rRNA - most abundant (Rampant)
mRNA - longest (Massive) tRNA - smallest (Tiny) |
|
mRNA start codon
|
AUG (inAUGurates protein synthesis)
|
|
mRNA stop codons
|
UGA (U Go Away)
UAA (U Are Away) UAG (U Are Gone) |
|
which types of RNA do the different types of RNA polymerase make?
|
RNA polymerase I - rRNA
RNA polymerase II - mRNA RNA polymerase III - tRNA (numbered in order as products are used in protein synthesis) |
|
exons vs. introns
|
exons are coding segments
introns are non-coding segments that are spliced out (INtrons stay IN the nucleus, whereas EXons EXit and are EXpressed) |
|
tetracyclines - mechanism of action?
|
bind 30S subunit and prevent attachment of aminoacyl-tRNA
|
|
subunits that make up the eukaryotic vs. prokaryotic ribosome
|
Eukaryotes: 40S + 60S = 80S (Even)
prOkaryotes: 30S + 50S = 70S (Odd) |
|
function of ribosome sites in protein synthesis
|
going APE:
A site - incoming Aminoacyl-tRNA binds here P site - accommodates growing Peptide E site - holds Empty tRNA as it Exits |
|
functions of ATP and GTP in protein synthesis
|
ATP - for tRNA charging (Activation)
GTP - for tRNA binding to ribosome and translocation (Gripping and Going places) |
|
aminoglycosides - mechanism of action?
|
inhibit formation of initiation complex in protein synthesis and cause misreading of mRNA
|
|
chloramphenicol - mechanism of action?
|
inhibits 50S peptidyltransferase (which catalyzes peptide bond formation)
|
|
mechanism of action of macrolides and clindamycin?
|
bind 50S subunit and block translocation
|
|
function of G1 and G2 phases in cell cycle
|
Gap or Growth (duplication of cell contents, cell growth)
|
|
function of S phase in cell cycle
|
DNA Synthesis
|
|
what is the defect in I-cell disease?
|
lysosomal storage disorder - failure of addition of mannose-6-phosphate to lysosome proteins (normally targets proteins to lysosomes)
- so enzymes are secreted from cell instead of going to lysosomes |
|
name 5 drugs that act on microtubules (and what they're used for)
|
mebendazole/thiabendazole (antihelminthic)
griseofulvin (antifungal) vincristine/vinblastine (anti-cancer) paclitaxel (anti-breast cancer) colchicine (anti-gout) |
|
what is the defect in Chediak-Higashi syndrome?
- symptoms? |
defect in microtubule polymerization, causing decreased phagocytosis
- symptoms: recurrent pyogenic infections, partial albinism, peripheral neuropathy |
|
what is the defect in Kartagener's syndrome?
- symptoms? |
dynein arm defect, causing cilia to be immotile
- symptoms: infertility, bronchiectasis, recurrent sinusitis, situs inversus |
|
mechanism of action of cardiac glycosides (digoxin and digitoxin)?
|
inhibit Na+/K+-ATPase, causing decreased Na+/Ca2+ exchange
- more Ca2+ in cell causes increased cardiac contractility |
|
location of the different types of collagen
|
Be (So Totally) Cool, Read Books
type I: Bone, Skin, Tendon (type I: bONE) type II: Cartilage (carTWOlage) type III (Reticulin): blood vessels, uterus, fetal tissue type IV: Basement membrane (type IV: under the floor) |
|
what is the defect in scurvy?
|
vitamin C deficiency, so can't hydroxylate proline and lysine residues in collagen
|
|
what is the defect in Ehlers-Danlos syndrome?
- which type of collagen is most affected? - symptoms? |
faulty collagen synthesis, especially type III collagen
- symptoms: hyperextensible skin, tendency to bleed, hypermobile joints |
|
what is the defect in osteogenesis imperfecta?
- which type of collagen is most affected? - symptoms? |
abnormal type I collagen synthesis
- symptoms: multiple fractures with minimal trauma (brittle bones), blue sclerae, hearing loss, dental imperfections |
|
what is the defect in Alport's syndrome?
- which type of collagen is most affected? - symptoms? |
abnormal type IV collagen synthesis
- symptoms: hereditary nephritis, deafness, ocular disturbances (type IV collagen found in kidney, ears, and eyes) |
|
what is the defect in Marfan's syndrome?
|
mutation in fibrillin (component of elastin)
|
|
what disease can be caused by alpha1-antitrypsin deficiency?
- why does this occur? |
emphysema - due to excess elastase activity (alpha1-antitrypsin normally inhibits elastase)
|
|
what blotting procedures are used to probe for DNA, RNA, and protein?
|
SNoW DRoP:
Southern = DNA Northern = RNA Western = Protein |
|
Prader-Willi vs. Angelman's syndrome - inactivation of which parent's allele?
|
Prader-Willi - deletion of Paternal allele
AngelMan's - deletion of Maternal allele |
|
what is the defect in hypophosphatemic rickets (vitamin D-resistant rickets)?
- what is the inheritance pattern? |
phosphate wasting at proximal tubule
- X-linked dominant |
|
what is the primary symptom in Leber's hereditary optic neuropathy?
- what causes this? - what is the inheritance pattern? |
loss of central vision due to degeneration of retinal ganglion cells and axons
- mitochondrial inheritance |
|
what gene is mutated in achondroplasia?
|
fibroblast growth factor receptor 3
|
|
what gene is mutated in ADPKD?
- what chromosome is it on? |
APKD1 gene
- on chromosome 16 (16 letters in "polycystic kidney") |
|
what gene is mutated in familial adenomatous polyposis?
- what chromosome is it located on? |
APC gene
- chromosome 5 (5 letters in "polyp") |
|
what is the defect in familial hypercholesterolemia?
|
defective or absent LDL receptor
|
|
what is Osler-Weber-Rendu syndrome?
|
hereditary hemorrhagic telangiectasia - disorder of blood vessels
|
|
what is the defect in hereditary spherocytosis?
|
defect in spectrin or ankyrin
|
|
what chromosome is the mutation in Huntington's disease located on?
|
chromosome 4 (hunting 4 food)
|
|
what chromosome is the mutated gene in neurofibromatosis type 1 (von Recklinghausen's disease) located on?
- symptoms? |
chromosome 17 (17 letters in von Recklinghausen)
- symptoms: cafe-au-lait spots, neural tumors, Lisch nodules (iris hamartomas) |
|
what gene is mutated in neurofibromatosis type 2?
- what chromosome is it on? - symptoms? |
NF2 gene on chromosome 22 (type 2 = 22)
- symptoms: bilateral acoustic neuromas, juvenile cataracts |
|
what are some symptoms of tuberous sclerosis?
|
facial lesions, hypopigmented "ash leaf spots" on skin, cortical/retinal hamartomas, renal cysts, cardiac rhabdomyomas
|
|
what are some symptoms of von Hippel-Lindau disease?
- what gene is mutated? - what chromosome is it on? |
hemangioblastomas, bilateral renal cell carcinomas
- VHL gene (tumor suppressor) on chromosome 3 (von Hippel-Lindau = 3 words) |
|
what gene is mutated in cystic fibrosis, and how?
- treatment? how does it work? |
CFTR - deletion of Phe 508
- N-acetylcysteine cleaves disulfide bonds in mucus |
|
name 10 X-linked recessive disorders
|
Be Wise, Fool's GOLD Heeds False Hope:
Bruton's agammaglobulinemia Wiskott-Aldrich syndrome Fragile X G6PD defiency Ocular albinism Lesch-Nyhan syndrome Duchenne's/Becker's muscular dystrophy Hemophilia A and B Fabry's disease Hunter's syndrome |
|
what is the gene defect in Duchenne's muscular dystrophy?
- what is the defect in Becker's? |
Duchenne's = Deleted Dystrophin (frameshift mutation)
- Becker's = mutated dystrophin |
|
what are the symptoms of fragile X syndrome?
|
macro-orchidism, long face, large jaw, large everted ears (fragile X = eXtra-large testes, jaw, ears)
|
|
name 4 trinucleotide repeat expansion diseases
- what are the repeated segments for each? |
Try (trinucleotide) hunting for my fried eggs (X):
Huntington's disease - CAG myoTonic dystrophy - CTG Friedreich's ataxia - GAA fraGile X syndrome - CGG |
|
name the 3 most common autosomal trisomies
- which chromosome? - symptoms? |
Down syndrome - 21 (Drinking age) - flat facies, prominent epicanthal folds, simian crease
Edward's syndrome - 18 (Election age) - micrognathia, low-set ears, clenched hands with overlapping fingers Patau's syndrome - 13 (Puberty) - cleft lip/Palate, holoProsencephaly, Polydactyly |
|
symptoms of 22q11 deletion syndromes
- what is the cause? - 2 examples of syndromes? |
CATCH-22:
Cleft palate Abnormal facies Thymic aplasia (causes T cell deficiency) Cardiac defects Hypocalcemia due to parathyroid aplasia - due to aberrant development of 3rd and 4th branchial pouches - examples: DiGeorge syndrome, velocardiofacial syndrome |
|
vitamin A - other name?
- function? |
retinol
- constituent of visual pigments (retin-A) |
|
vitamin B1 - other name?
- what cofactor does it make? - what types of reactions does this assist in? - what diseases are caused by deficiency? |
thiamine
- TPP - for dehydrogenase reactions - beriberi (Ber1Ber1) and Wernicke-Korsakoff syndrome |
|
vitamin B2 - other name?
- what cofactors does it make? how many ATP? - symptoms of deficiency? |
riboflavin
- FAD and FMN (derived from riboFlavin) - FAD makes 2 ATP (B2) - 2 C's: Cheilosis, Corneal vascularization |
|
vitamin B3 - other name?
- what cofactor does it make? how many ATP? - what disease is caused by deficiency? symptoms? |
niacin
- NAD (derived from Niacin) - 3 ATP (B3) - pellagra - 3 D's: Diarrhea, Dermatitis, Dementia |
|
vitamin B5 - other name?
- what cofactor does it make? |
pantothenate
- CoA (from pantothen-A) |
|
vitamin B6 - other name?
- what types of reactions does it participate in? |
pyridoxine
- transamination and decarboxylation reactions |
|
vitamin B12 - other name?
|
cobalamin
|
|
source of folate
|
green leaves (FOLate from FOLiage)
|
|
function of S-adenosyl-methionine
|
transfers methyl units (SAM the methyl donor man)
|
|
biotin - cofactor in what kind of reactions?
- cause of deficiency? |
carboxylation reactions
- ingestion of raw eggs, which contain avidin (AVIDin in egg whites AVIDly binds biotin) |
|
vitamin E - function?
|
antioxidant that protects erythrocytes and membranes from damage (E for Erythrocytes)
|
|
vitamin K - function?
|
needed for proper function of clotting factors II, VII, IX, and X and proteins C and S (K is for Koagulation)
|
|
disulfiram - mechanism of action?
|
inhibits acetaldehyde dehydrogenase, causing accumulation of acetaldehyde
|
|
kwashiorkor vs. marasmus - what are the causes and symptoms of each?
|
kwashiorkor - protein malnutrition
- results from a protein-deficient MEAL: malnutrition, edema, anemia, liver fatty change marasmus - energy malnutrition - Marasmus results in Muscle wasting |
|
cell processes that take place in both mitochondria and cytoplasm
|
HUGs take two:
Heme synthesis Urea cycle Gluconeogenesis |
|
hexokinase vs. glucokinase
- what do they do? - where are they each located? - high or low affinity? - high or low Vmax? |
both convert glucose to glucose-6-phosphate
- hexokinase is everywhere and has high affinity and low Vmax - glucokinase is in liver and beta cells of pancreas - has low affinity and high Vmax |
|
cofactors involved in pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase reactions
|
TPP (B1), FAD (B2), NAD (B3), CoA (B5), lipoic acid
|
|
purely ketogenic amino acids
|
Lysine and Leucine
|
|
substrates in TCA cycle
|
Citrate Is Krebs' Starting Substrate For Making Oxaloacetate:
Citrate - Isocitrate - alpha-Ketoglutarate - Succinyl-CoA - Succinate - Fumarate - Malate - Oxaloacetate |
|
enzymes unique to gluconeogenesis (all irreversible)
|
Pathway Produces Fresh Glucose:
Pyruvate carboxylase PEP carboxykinase Fructose-1,6-bisphosphatase Glucose-6-phosphatase |
|
purposes of HMP shunt
|
produce NADPH (for fatty acid/steroid biosynthesis and glutathione reduction to prevent oxidative damage)
produce pentose sugars (for nucleotide synthesis) |
|
what are Heinz bodies?
- what disease do they occur in? |
Heinz bodies = denatured Hemoglobin that precipitates within RBCs
- occur in G6PD deficiency (oxidative damage) |
|
what is the defect in fructose intolerance?
|
deficiency of aldolase B (converts fructose-1-P to DHAP and glyceraldehyde)
|
|
what is the defect in essential fructosuria?
|
deficiency of fructokinase (converts fructose to fructose-1-P)
|
|
what is the defect in classic galactosemia?
- symptoms? |
absence of galactose-1-phosphate uridyltransferase (converts galactose-1-P to glucose-1-P)
- failure to thrive, infantile cataracts (galactitol accumulates in eye) |
|
substrates in urea cycle
|
Ordinarily, Careless Crappers Are Also Frivolous About Urination:
Ornithine - Carbamoyl phosphate - Citrulline - Aspartate - Argininosuccinate - Fumarate - Arginine - Urea |
|
what is the defect in phenylketonuria?
- symptoms? |
decrease in phenylalanine hydroxylase (converts Phe to Tyr) or in THB cofactor
- mental/growth retardation, fair skin, musty body odor (disorder of aromatic aa metabolism causes musty body odor) |
|
what is the defect in alkaptonuria?
- symptoms? |
deficiency of homogentisic acid oxidase (involved in Tyr degradation)
- dark connective tissue, pigmented sclera, urine turns black on standing |
|
what is the defect in albinism?
|
deficiency of tyrosinase or defective tyrosine transporters (so can't make melanin from tyrosine)
|
|
what is the defect in homocystinuria?
|
defect in cystathionine synthase (in pathway converting homocysteine to cysteine) or in homocysteine methyltransferase (converts homocysteine to methionine) - both cause excess homocysteine
|
|
what is the defect in cystinuria?
- what can result? |
defect of renal proximal tubule transporter for cysteine
- excess cystine in urine can cause precipitation of cystine kidney stones |
|
what is the defect in maple syrup urine disease?
- symptoms? |
defect in alpha-ketoacid dehydrogenase, which degrades branched amino acids (Ile, Leu, Val - I Love Vermont maple syrup from the branches of maple trees)
- urine smells like maple syrup, CNS defects |
|
what enzyme deficiency is a major cause of SCID?
- what patient population gets SCID? |
adenosine deaminase deficiency (excess ATP imbalances nucleotide pool and prevents DNA synthesis)
- SCID happens to kids |
|
what is the defect in Lesch-Nyhan syndrome?
- symptoms? |
absence of HGPRT (He's Got Purine Recovery Trouble) - enzyme of purine salvage pathway, so block leads to excess uric acid
- retardation, self-mutilation, gout |
|
what is the defect in orotic aciduria?
- findings? |
inability to convert orotic acid to UMP (in de novo pyrimidine synthesis pathway)
- orotic acid in urine, megaloblastic anemia |
|
function of insulin with regard to glucose
|
Insulin moves glucose Into cells
|
|
tissues that don't need insulin for glucose transport
|
BRICK L:
Brain, RBCs, Intestine, Cornea, Kidney, Liver |
|
what are glycogen storage diseases types I-III and V?
- what enzymes are deficient in each? - what specific organs do types II and V affect? |
Very Poor Carbohydrate Metabolism:
I = Von Gierke's disease - glucose-6-phosphatase II = Pompe's disease - lysosomal alpha-1,4-glucosidase - heart (cardiomegaly) - Pompe's trashes the Pump III = Cori's disease - debranching enzyme V = McArdle's disease - skeletal muscle glycogen phosphorylase - muscle (McArdle's = Muscle) |
|
what is the defect in Fabry's disease?
- what substrate accumulates? |
deficient alpha-galactosidase A
- ceramide trihexoside accumulates |
|
what is the defect in Gaucher's disease?
- what substrate accumulates? |
deficient beta-glucocerebrosidase
- glucocerebroside accumulates |
|
what is the defect in Niemann-Pick disease?
- what substrate accumulates? |
deficient sphingomyelinase - no man picks (Niemann-Pick) his nose with his sphinger (sphingomyelinase)
- sphingomyelin accumulates |
|
what is the defect in Tay-Sachs disease?
- what substrate accumulates? |
deficient hexosaminidase A (Tay-SaX lacks heXosaminidase)
- GM2 ganglioside accumulates |
|
what is the defect in Krabbe's disease?
- what substrate accumulates? |
deficient galactocerebrosidase
- galactocerebroside accumulates |
|
what is the defect in metachromatic leukodystrophy?
- what substrate accumulates? |
deficient arylsulfatase A
- cerebroside sulfate accumulates |
|
what is the defect in Hurler's syndrome?
- what substrates accumulate? |
deficient alpha-L-iduronidase
- heparan sulfate and dermatan sulfate accumulate |
|
what is the defect in Hunter's syndrome?
- what substrates accumulate? - what is the inheritance pattern? |
deficient iduronate sulfatase
- heparan sulfate and dermatan sulfate accumulate - X-linked recessive (hunters aim for the X) |
|
Hunter's vs. Hurler's - which has corneal clouding?
|
Hurler's
(hunters see clearly - no corneal clouding) |
|
citrate shuttle vs. carnitine shuttle - what metabolic pathways are they involved in?
|
citrate - fatty acid synthesis (SYtrate = SYnthesis)
carnitine - fatty acid degradation (CARnitine = CARnage of fatty acids) |
|
statins - mechanism of action?
|
inhibit HMG-CoA reductase
|
|
functions of apolipoproteins A-I, B-100, C-II, B-48, and E
|
A-I - activates LCAT
B-100 - Binds LDL receptor and mediates VLDL secretion C-II - Cofactor for lipoprotein lipase B-48 - mediates chylomicron secretion E - mediates remnant (Extra) uptake |
|
direction of transport of LDL and HDL
|
LDL - from liver to tissues (LDL is Lousy)
HDL - from periphery to liver (HDL is Healthy) |
|
what is the defect in hyperchylomicronemia?
|
lipoprotein lipase deficiency or altered apolipoprotein C-II
|
|
what is the defect in familial hypercholesterolemia?
|
absent or decreased LDL receptors
|
|
what is the defect in hypertriglyceridemia?
|
hepatic overproduction of VLDL
|
|
what is the defect in abetalipoproteinemia?
|
deficiencies of apoB-100 and apoB-48 - unable to synthesize lipoproteins
|
|
landmarks of 2nd week of fetal development
|
rule of 2's:
- 2 germ layers (epiblast, hypoblast) - 2 cavities (amniotic cavity, yolk sac) - 2 components to placenta (cytotrophoblast, syncytiotrophoblast) |
|
landmark of 3rd week of fetal development
|
rule of 3's:
- 3 germ layers (ectoderm, mesoderm, endoderm) |
|
landmarks of 4th week of fetal development
|
rule of 4's:
- 4 heart chambers - 4 limb buds grow |
|
what germ layer are odontoblasts derived from?
|
neural crest (Crest toothpaste)
|
|
symptoms of mesoderm defects
|
VACTERL:
Vertebral defects Anal atresia Cardiac defects Tracheo-Esophageal fistula Renal defects Limb defects |
|
at which days in fetal development do the amnion and chorion form?
|
chorion forms at day 3
amnion forms at day 8 |
|
what are the components of the umbilical cord?
|
2 umbilical arteries
1 umbilical vein urachus all surrounded by Wharton's jelly |
|
structures that perform fetal erythropoiesis during development, in order
|
Young Liver Synthesizes Blood:
Yolk sac (3-8 wk) Liver (6-30 wk) Spleen (9-28 wk) Bone marrow (28+ wk) |
|
what is the adult derivative of the umbilical arteries?
|
umbiLical arteries become mediaL umbilical ligaments
|
|
what is the adult derivative of the allantois/urachus?
|
allaNtois becomes mediaN umbilical ligaments
|
|
what is the adult derivative of the 1st aortic arch?
|
part of the MAXillary artery (1st arch is MAXimal)
|
|
what are the adult derivatives of the 2nd aortic arch?
|
Stapedial artery (Second arch) and hyoid artery
|
|
what are the adult derivatives of the 3rd aortic arch?
|
common Carotid artery and internal Carotid artery (C is 3rd letter of alphabet)
|
|
what are the adult derivatives of the 4th aortic arch?
|
aortic arch and right subclavian artery (4th arch = 4 limbs = systemic circulation)
|
|
what is the defect in spina bifida occulta?
- in meningocele? - in myelomeningocele? |
bony spinal canal fails to close, but no herniation
- meninges herniate through - meninges and spinal cord herniate through |
|
what is Chiari type II?
|
cerebellar tonsils herniate through foramen magnum
|
|
what is Dandy-Walker?
|
large posterior fossa, absent cerebellum, enlarged 4th ventricle
|
|
what is the defect in holoprosencephaly?
|
cerebral hemispheres do not separate across midline
|
|
what is the defect in syringomyelia?
- symptom? |
enlarged central canal of spinal cord - damages crossing fibers of spinothalamic tract
- so bilateral loss of pain and temperature sense |
|
what germ layers are the different parts of the branchial apparatus derived from?
|
CAP covers outside from inside:
Clefts = ectoderm Arches = mesoderm Pouches = endoderm |
|
innervations and general functions of derivatives of each branchial arch
|
arch 1 - CN V2 and V3 - chewing
arch 2 - CN VII - facial expression arch 3 - CN IX - stylopharyngeus arch 4 - CN X - swallowing arch 6 - CN X - speaking |
|
name some derivatives of branchial arch 1
|
Meckel's cartilage (Mandible, Malleus, incus, sphenoMandibular ligament)
Muscles of Mastication (temporalis, Masseter, lateral and Medial pterygoids) Mylohyoid, anterior belly of digastric, tensor tympani, tensor veli palatini, anterior tongue |
|
what is the defect in Treacher Collins syndrome?
- symptoms? |
1st arch neural crest fails to migrate
- mandibular hypoplasia, facial abnormalities |
|
name some derivatives of branchial arch 2
|
Stapes, Styloid process, lesser horn of hyoid, Stylohyoid ligament
muscles of facial expression, Stapedius, Stylohyoid, posterior belly of digastric |
|
name some derivatives of branchial arch 3
|
greater horn of hyoid, stylopharyngeus (innervated by glossopharyngeal nerve)
|
|
what are the derivatives of the 3rd branchial pouch?
|
3rd pouch contributes to 3 structures:
thymus and inferior parathyroids |
|
what is the defect in DiGeorge syndrome?
- symptoms? |
aberrant development of 3rd and 4th branchial pouches (form thyroid and parathyroids)
- T-cell deficiency and hypocalcemia |
|
what ear bones and muscles derive from the 1st branchial arch?
- from the 2nd? |
1st: Malleus/incus, tensor tyMpani
2nd: Stapes, Stapedius |
|
embryologic components of diaphragm
|
Several Parts Build Diaphragm:
Septum transversum Pleuroperitoneal folds Body wall Dorsal mesentery of esophagus |
|
innervation of diaphragm
|
C3,4,5 (keeps the diaphragm alive)
|
|
what is the defect in gastroschisis?
|
failure of lateral body folds to fuse, causes extrusion of abdominal contents
|
|
what is the defect in Potter's syndrome?
- symptoms? |
bilateral renal agenesis in utero (due to malformed ureteric bud) causes oligohydramnios (babies with Potter's can't Pee in utero)
- limb deformities, face deformities, pulmonary hypoplasia |
|
adult derivatives of the mesonephric (wolffian) ducts
|
SEED:
Seminal vesicles Epididymis Ejaculatory duct Ductus deferens |
|
what is the defect in hypospadias?
|
failure of urethral folds to close - causes abnormal opening of penile urethra on inferior side of penis (hypo is below)
|
|
what is the defect in epispadias?
- what condition is associated with epispadias? |
faulty positioning of genital tubercle - causes abnormal opening of penile urethra on superior side of penis (Epispadias - you hit your Eye when you pEE)
- Extrophy of the bladder is associated with Epispadias |
|
only bacteria with a protein capsule
|
Bacillus anthracis
|
|
bacteria that do not Gram stain well
|
These Rascals May Microscopically Lack Color:
Treponema Rickettsia Mycobacteria Mycoplasma Legionella pneumophila Chlamydia |
|
what does PAS stain for?
- what does it diagnose? |
glycogen and mucopolysaccharides (PASs the sugar)
- Whipple's disease |
|
name 4 obligate aerobes
|
Nagging Pests Must Breathe:
Nocardia Pseudomonas aeruginosa (P. AERuginosa is an AERobe) Mycobacterium tuberculosis Bacillus |
|
name 3 obligate anaerobes
|
anaerobes Can't Breathe Air:
Clostridium Bacteroides Actinomyces |
|
what type of bacteria are aminoglycosides ineffective against?
|
anaerobes (aminO2glycosides require O2 to enter bacterial cell)
|
|
name 2 obligate intracellular bacteria
|
stay inside cells when it's Really Cold:
Rickettsia Chlamydia |
|
name 8 facultative intracellular bacteria
|
Some Nasty Bugs May Live FacultativeLY:
Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia |
|
what does a positive quellung reaction indicate?
|
bacteria is encapsulated (quellung = capsular swellung)
|
|
name 4 encapsulated bacteria
|
Some Nasties Have Kapsules:
Streptococcus pneumoniae Neisseria meningitidis Haemophilus influenzae Klebsiella pneumoniae |
|
name 4 urease-positive bacteria
|
Particular Kinds Have Urease:
Proteus Klebsiella H. pylori Ureaplasma |
|
what bacteria produce a yellow pigment?
|
S. aureus (aureus = yellow)
|
|
what bacteria produce a blue-green pigment?
|
Pseudomonas aeruginosa (AERUGula is green)
|
|
what bacteria produce a red pigment?
|
Serratia marcescens (red maraschino cherries)
|
|
function of Corynebacterium diphtheriae toxin
|
inactivates elongation factor (EF-2)
|
|
function of Vibrio cholerae toxin
|
activates Gs, stimulating adenylyl cyclase - increases Cl- in gut and decreases Na+ absorption
|
|
E. coli heat-labile toxin vs. heat-stable toxin
|
heat-labile stimulates Adenylate cyclase, heat-stable stimulates Guanylate cyclase
("labile like the Air, stable like the Ground") |
|
function of Bordetella pertussis toxin
|
inhibits Gi, causing increased cAMP
|
|
function of C. tetani toxin
|
blocks release of GABA and glycine
|
|
function of C. botulinum toxin
|
blocks release of acetylcholine
|
|
function of Shigella toxin
|
Shiga toxin cleaves host rRNA and enhances cytokine release
|
|
location of endotoxin
|
Gram-Negative cell wall
(N-dotoxin) |
|
name 5 bacterial toxins that are encoded in a lysogenic phage
|
ABCDE:
ShigA-like toxin Botulinum toxin Cholera toxin Diphtheria toxin Erythrogenic toxin of Streptococcus pyogenes |
|
how do you distinguish between Staph. epidermidis and Staph. saprophyticus?
|
NOvobiocin - Saprophyticus is Resistant, Epidermidis is Sensitive (on the office's staph retreat, there was NO StRES)
|
|
how do you distinguish between Strep. pneumoniae and viridans?
|
Optochin - Viridans is Resistant, Pneumoniae is Sensitive (OVRPS - overpass)
|
|
how do you distinguish between group A and B strep?
|
Bacitracin - group B strep are resistant, group A are Sensitive (B-BRAS)
|
|
how do you distinguish between Staphylococci and Streptococci?
|
catalase (Staph make catalase because they have more staff)
|
|
what diseases does Streptococcus pneumoniae cause?
|
MOPS (Most OPtochin Sensitive):
Meningitis Otitis media Pneumonia Sinusitis |
|
what species of viridans group Strep causes subacute bacterial endocarditis?
|
S. sanguis (blood - there is lots of blood in the heart)
|
|
normal location of viridans Streptococci
|
in the mouth (not afraid of-the-chin - op-to-chin resistant)
|
|
sequelae of Strep pharyngitis
|
rheumatic fever (PHever), glomerulonePHritis (due to PHaryngitis)
|
|
symptoms of rheumatic fever
|
no rheum for SPECCulation:
Subcutaneous nodules Polyarthritis Erythema marginatum Chorea Carditis |
|
what patients does Streptococcus agalactiae infect?
|
babies (group B is for Babies)
|
|
characteristics of Corynebacterium diphtheriae
|
ABCDEFG:
ADP ribosylation (by toxin) Beta-prophage (encodes toxin) Corynebacterium Diphtheriae Elongation Factor 2 (ribosylated by toxin) Granules |
|
main symptom of Clostridium tetani infection
|
TETanic paralysis (TETanus)
|
|
what are the sources of C. botulinum?
|
BOTulinum - from bad BOTtles of food and honey
|
|
what does C. perfringens infection cause?
|
gas gangrene (PERFringens PERForates a gangrenous leg)
|
|
what does C. difficile infection cause?
|
DIfficile - causes DIarrhea and pseudomembranous colitis
|
|
what is the only Gram-positive bacteria with endotoxin?
|
Listeria monocytogenes
|
|
what are the treatments for Actinomyces israelii and Nocardia asteroides?
|
SNAP:
Sulfamethoxazole for Nocardia Actinomyces gets Penicillin |
|
lepromatous vs. tuberculoid leprosy - which is worse?
- what causes the difference? |
LEpromatous is worse (LEthal)
- due to failed cell-mediated immunity |
|
what type of bacteria grow pink colonies on MacConkey's agar?
- name 5 examples |
lactose fermenters (lactose is KEE)
- MacConKEE's agar: Citrobacter, Klebsiella, E. coli, Enterobacter, Serratia |
|
how do you distinguish between Neisseria gonorrhoeae and meningitidis?
|
MeninGococci ferment Maltose and Glucose
Gonococci ferment only Glucose |
|
what diseases does Haemophilus influenzae cause?
|
HaEMOPhilus causes Epiglottitis, Meningitis, Otitis media, Pneumonia
|
|
what special culture is needed to grow Haemophilus influenzae?
|
chocolate agar with factors V (NAD) and X (hematin)
(when a child has the "flu", mom goes to the five (V) and dime (X) to buy some chocolate) |
|
how do you stain Legionella pneumophila?
- what special culture is needed to grow it? |
silver stain
- charcoal yeast extract with iron and cysteine (French legionnaire with silver helmet sitting around charcoal fire with an iron dagger - he is no sissy/cysteine) |
|
what diseases does Pseudomonas aeruginosa cause?
|
PSEUDOmonas - Pneumonia, Sepsis, External otitis, UTI, Diabetic Osteomyelitis
|
|
antigen types found in Enterobacteriaceae
- are they glucose fermenters or nonfermenters? |
COFFEe:
Capsular (K) antigen O antigen Flagellar (H) antigen Ferment glucose Enterobacteriaceae |
|
what diseases does Klebsiella cause?
- what patients does it affect? |
4 A's:
Aspiration pneumonia Abscess in lungs Alcoholics di-A-betics |
|
Salmonella vs. Shigella - which is motile?
- how are they transmitted? |
Salmonella (salmon swim)
- Food, Fingers, Feces, Flies |
|
name the spirochetes
- which is the biggest? |
BLT: Borrelia, Leptospira, Treponema
- Borrelia (B is Big) |
|
what is Weil's disease?
|
icterohemorrhagic leptospirosis (severe infection with Leptospira interrogans)
|
|
symptoms of Lyme disease
|
BAKE a Key Lyme pie:
Bell's palsy Arthritis Kardiac block Erythema migrans |
|
which stage of syphilis is characterized by systemic disease?
|
Secondary syphilis = Systemic
|
|
what is the Argyll Robertson pupil?
|
sign of tertiary syphilis - constricts with accommodation but is not reactive to light (prostitute's pupil - accommodates but doesn't react)
|
|
which treponeme test is more specific and remains positive longest: FTA-ABS or VDRL?
|
FTA-ABS (Find The Antibody ABSolutely)
|
|
causes of VDRL false positives
|
VDRL:
Viruses (mono, hepatitis) Drugs Rheumatic fever Lupus/leprosy |
|
name 6 zoonotic bacteria
|
Big Bad Bugs From Your Pet named Ella:
Bartonella henselae Borrelia burgdorferi Brucella Francisella tularensis Yersinia pestis Pasteurella multocida |
|
what is the source of Brucella, and what does it cause?
|
Unpasteurized dairy products - causes Undulant fever
|
|
triad of symptoms caused by rickettsiae
|
headache, fever, rash
|
|
what distinguishes rickettsial rash from typhus rash?
|
rickettsial rash starts on hands and feet and spreads inward
typhus rash starts centrally and spreads outward (Rickettsia on the wRists, Typhus on the Trunk) |
|
what causes Q fever, and what distinguishes it from other rickettsiae?
|
Coxiella burnetii
Q fever is Queer - no rash, no vector (transmitted by aerosol), negative Weil-Felix reaction, organism can survive outside for a long time |
|
what infections cause a palm and sole rash?
|
drive CARS using palms and soles:
Coxsackievirus A Rocky Mountain spotted fever Syphilis |
|
Chlamydia elementary body vs. reticulate body - what is the function of each?
|
Elementary body Enters the cell
Reticulate body Replicates in the cell |
|
what do the different serotypes of Chlamydia trachomatis cause?
|
types A, B, C - in Africa, cause Blindness and Chronic infection
types L1-3 - cause Lymphogranuloma venereum types D-K - cause everything else |
|
treatment for C. difficile
|
metronidazole
|
|
treatment for leprosy
- side effects? |
dapsone
- hemolysis, methemoglobinemia |
|
treatment for H. influenzae meningitis
- prophylaxis for close contacts? |
ceftriaxone
- rifampin prophylaxis |
|
treatment for Legionella
|
erythromycin
|
|
treatment for Pseudomonas
|
aminoglycoside + extended-spectrum penicillin
|
|
treatment for H. pylori
|
triple therapy: bismuth, metronidazole, and tetracycline/amoxicillin
|
|
treatment for Lyme disease
|
doxycycline
|
|
treatment for syphilis
|
penicillin
|
|
treatment for Gardnerella
|
metronidazole
|
|
treatment for Rickettsiae
|
tetracycline
|
|
treatment for Chlamydia
|
erythromycin or tetracycline
|
|
treatment for Mycoplasma pneumoniae
|
tetracycline or erythromycin
|
|
histoplasmosis - where is it contracted?
- microscopic appearance? |
Mississippi/Ohio river valleys
- macrophage filled with intracellular oval bodies |
|
blastomycosis - where is it contracted?
- microscopic appearance? - preferred form at different temperatures? |
east of Mississippi river
- Blastomycosis = Big Broad-Based Budding - cold = mold, heat = yeast |
|
coccidioidomycosis - where is it contracted?
- microscopic appearance? |
southwestern US
- spherule filled with endospores |
|
paracoccidioidomycosis - where is it contracted?
- microscopic appearance? |
Latin America
- budding yeast looks like captain's wheel |
|
treatment for local mycotic infection
- for systemic infection? |
fluconazole or ketoconazole
- amphotericin B for systemic |
|
what causes tinea versicolor?
- treatment? |
Malassezia furfur
- miconazole, selenium sulfide |
|
treatment for superficial Candida albicans infection
- for systemic infection? |
nystatin
- amphotericin B for systemic |
|
treatment for Pneumocystis jiroveci
|
trimethaprim-sulfamethoxazole
|
|
treatment for Sporothrix schenckii
|
itraconazole or potassium iodide
|
|
symptoms of Chagas' disease
- what causes it? - what transmits it? - treatment? |
dilated cardiomyopathy, megacolon, megaesophagus
- Trypanosoma cruzi transmitted by reduviid bug - nifurtimox |
|
treatment for African sleeping sickness
|
SURamin for blood-borne disease
MELArsoprol for CNS penetration (it SURe is nice to go to sleep; MELAtonin helps with sleep) |
|
how is Leishmania transmitted?
- treatment? |
sandfly
- treat with sodium stibogluconate |
|
treatment for malaria
|
chloroquine + primaquine to prevent relapse by dormant species in liver
|
|
what organisms does the Ixodes tick transmit?
|
Borrelia burgdorferi and Babesia
|
|
what is the main symptom of Entamoeba histolytica infection?
|
bloody diarrhea
|
|
what are three main drugs used to treat nematode (roundworm) infections?
|
meBENDazole (worms are BENDy), pyrantel pamoate, diethylcarbamazine
|
|
what disease does Onchocerca volvulus cause?
- treatment? - how is it transmitted? |
rIVER blindness
- IVERmectin - blackflies |
|
what is the main drug used to treat cestode (tapeworm) and trematode (fluke) infections?
|
praziquantel
|
|
Taenia solium - what are the two types of infection?
- ingestion of which form causes each? |
intestinal tapeworms - caused by ingestion of larvae
cysticercosis - caused by ingestion of eggs |
|
infection by what causes cysts in liver?
- what happens if the cysts burst? |
Echinococcus granulosus
- anaphylactic reaction |
|
what parasite is associated with squamous cell carcinoma of the bladder?
|
Schistosoma haematobium
|
|
what parasite is associated with cholangiocarcinoma?
|
Clonorchis sinensis
|
|
what nematodes are spread by ingestion?
|
you'll get sick if you EAT these:
Enterobius Ascaris Trichinella |
|
nematodes that spread cutaneously
|
these get into your feet from the SANd:
Strongyloides Ancylostoma Necator |
|
what parasite can cause vitamin B12 deficiency?
|
Diphyllobothrium latum
|
|
what parasites can cause microcytic anemia?
|
Ancylostoma and Necator
|
|
what parasite can cause perianal pruritis?
|
Enterobius
|
|
what organism causes typhoid fever?
|
Salmonella typhi
|
|
name 3 organisms that cause typhus (and what kind of typhus they cause)
|
Rickettsia prowazekii (epidemic)
Rickettsia typhi (endemic) Rickettsia tsutsugamushi (scrub typhus) |
|
live vs. killed vaccines - what type of immunity is induced?
|
live - humoral and cell-mediated immunity
killed - only humoral immunity |
|
which viral vaccines are killed vaccines?
|
RIP Always:
Rabies Influenza Salk Polio HAV |
|
Sabin vs. Salk polio vaccines - which is killed, and which is live?
|
Sabin - live
SalK - Killed |
|
are DNA viruses single-stranded or double-stranded?
- exception? |
double-stranded
- parvovirus is exception ("part-of-a-virus") |
|
are DNA viruses linear or circular?
- exceptions? |
linear
- exceptions: papilloma, polyoma, hepadna are circular |
|
are RNA viruses single-stranded or double-stranded?
- exception? |
single-stranded
- exception: reovirus ("repeatovirus") is double-stranded |
|
are viruses haploid or diploid?
- exception? |
haploid
- exception: retroviruses are diploid |
|
where do DNA viruses replicate?
- exception? |
nucleus
- exception: poxvirus replicates in the cytoplasm |
|
where do RNA viruses replicate?
- exceptions? |
cytoplasm
- exceptions: influenza virus and retroviruses replicate in the nucleus |
|
name the nonenveloped viruses (and whether they are DNA or RNA)
|
naked CPR and PAPP smear:
RNA: Calicivirus, Picornavirus, Reovirus DNA: Parvovirus, Adenovirus, Papillomavirus, Polyomavirus |
|
name the DNA viruses
|
HHAPPPPy:
Hepadna Herpes Adeno Pox Parvo Papilloma Polyoma |
|
do DNA viruses have icosahedral or complex nucleocapsids?
- exception? |
icosahedral
- exception: pox (complex) |
|
name the herpesviruses
|
get herpes in a CHEVrolet:
CMV HSV EBV VZV |
|
what does the Tzanck test look for?
- what does it test for? |
multinucleated giant cells
- HSV-1, HSV-2, VZV (Tzanck heavens I don't have herpes) |
|
what viruses are paramyxoviruses?
|
PaRaMyxovirus:
Parainfluenza RSV Measles (rubeola) Mumps |
|
what is the treatment for RSV?
|
ribavirin
|
|
what RNA viruses are negative-stranded?
|
Always Bring Polymerase Or Fail Replication:
Arenavirus Bunyavirus Paramyxovirus Orthomyxovirus Filovirus Rhabdovirus |
|
what RNA viruses are segmented?
|
BOAR:
Bunyavirus Orthomyxovirus Arenavirus Reovirus |
|
what viruses are picornaviruses?
- RNA or DNA viruses? |
PERCH on a peak (pico):
Poliovirus Echovirus Rhinovirus Coxsackievirus HAV - RNA viruses (picoRNAvirus) |
|
what disease does rhinovirus cause?
|
common cold (rhino has a runny nose)
|
|
what virus causes yellow fever?
|
flavivirus (flavi = yellow)
|
|
what disease does rotavirus cause?
|
infantile gastroenteritis (ROTA = RIght Out The Anus)
|
|
genetic drift vs. genetic shift - which causes epidemics and which pandemics of influenza virus?
|
drift - epidemics
shift - pandemics (Sudden Shift is more deadly than graDual Drift) |
|
what are the main symptoms of measles?
|
3 C's:
Cough, Coryza, Conjunctivitis + Koplik's spots |
|
what are the main symptoms of mumps?
|
Parotitis, Orchitis, aseptic Meningitis
(make your parotid glands and testes as big as POM-poms) |
|
name 3 arboviruses
- what are arboviruses? |
ARBOvirus = ARthropod-BOrne virus
- Flavivirus, Togavirus, Bunyavirus (Fever Transmitted by Bites) |
|
what type of infection does hepatitis A cause?
|
hep A:
usually Asymptomatic, Acute |
|
how is hepatitis B transmitted?
|
hep B:
Blood-borne |
|
what type of infection does hepatitis C cause?
- what are possible sequelae? |
hep C:
Chronic infection can cause Cirrhosis and Carcinoma |
|
what does hepatitis D require to infect?
|
HBV
(hep D is Defective and Dependent on HBV) |
|
how is hepatitis E transmitted?
- what patient population is particularly at risk? |
hep E:
Enteric (can cause Epidemics) Expectant mothers (pregnant women) have high mortality |
|
which hepatitis viruses are transmitted by fecal-oral route?
|
hepatitis A and E ("the vowels hit your bowels")
|
|
what does ABcAb indicate?
|
IgM HBcAb - recent disease
IgG HBcAb - chronic disease |
|
what does HBeAb indicate?
|
HBeAb = low transmissibility
(HBeAg = high transmissibility - Beware!) |
|
what receptors does HIV virus bind on T cells?
- on macrophages? |
T cells - CD4 and CXCR4
macrophages - CD4 and CCR5 |
|
4 stages of HIV infection
|
1 - Flulike (acute)
2 - Feeling fine (latent) 3 - Falling CD4 count 4 - Final crisis (AIDS) |
|
what is Bacillus cereus contracted from?
|
reheated rice (food poisoning from reheated rice? Be serious/B. cereus!)
|
|
4 most common causes of pneumonia in children
|
Runts May Cough Sputum:
RSV Mycoplasma Chlamydia pneumoniae Streptococcus pneumoniae |
|
most common cause of pneumonia in hospitalized and immunocompromised patients
|
Staphylococcus
|
|
most common cause of aspiration pneumonia
|
anaerobes
|
|
most common cause of osteomyelitis in diabetics and drug addicts
|
Pseudomonas aeruginosa
|
|
most common cause of osteomyelitis in sickle cell patients
|
Salmonella
|
|
name 7 bacteria that cause UTIs
|
SSEEK PP:
Serratia marcescens Staphylococcus saprophyticus Escherichia coli Enterobacter cloacae Klebsiella pneumoniae Proteus mirabilis Pseudomonas aeruginosa |
|
name 6 infections that are transmitted in utero or during birth
|
ToRCHeS:
Toxoplasma gondii Rubella CMV HIV HSV-2 Syphilis |
|
what organism causes a painful genital ulcer?
|
Haemophilus ducreyi (it's so painful, you do cry)
|
|
what is Fitz-Hugh-Curtis syndrome a complication of?
- what are the characteristics? |
PID
- infection of liver capsule with "violin string" adhesions to parietal peritoneum |
|
what is the most common nosocomial infection caused by respiratory therapy equipment?
|
Pseudomonas AERuginosa (involves AIR)
|
|
name 6 bacteriostatic antibiotics
|
we're ECSTaTiC about bacteriostatics:
Erythromycin Clindamycin Sulfamethoxazole Trimethoprim Tetracyclines Chloramphenicol |
|
name 6 bactericidal antibiotics
|
Very Finely Proficient At Cell Murder:
Vancomycin Fluoroquinolones Penicillin Aminoglycosides Cephalosporins Metronidazole |
|
penicillin - mechanism of action?
- toxicity? |
blocks transpeptidase cross-linking of cell wall
- hypersensitivity reaction |
|
what class of drugs are methicillin, nafcillin, and dicloxacillin?
- what bacteria are they used for? - side effect of methicillin? |
penicillinase-resistant penicillins
- S. aureus (but not MRSA) - interstitial nephritis |
|
what class of drugs are ampicillin and amoxicillin?
- which has greater oral bioavailability? - what Gram-negative rods do they kill? |
aminopenicillins - extended spectrum (AMPed up penicillin)
- amOxicillin has greater Oral bioavailability - HELPS kill enterococci: Haemophilus influenzae, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella |
|
name 3 antipseudomonal penicillins
|
Ticarcillin, Carbenicillin, Piperacillin (TCP = Takes Care of Pseudomonas)
|
|
what Gram-negatives are covered by 1st generation cephalosporins?
- by 2nd generation? |
1st: PEcK = Proteus mirabilis, E. coli, Klebsiella pneumoniae
2nd: HEN PEcKS = Haemophilus influenzae, Enterobacter aerogenes, Neisseria, Proteus mirabilis, E. coli, Klebsiella pneumoniae, Serratia marcescens |
|
side effect of cephalosporins
|
disulfiram-like reaction with ethanol
|
|
beta-lactamase-resistant monobactam
- what does it treat? - who is it used for? |
aztreonam
- Gram-negative rods - penicillin-allergic patients |
|
what is imipenem always administered with?
- why? |
cilastatin - inhibits renal dihydropeptidase I and decreases renal inactivation of imipenem (with imipenem, the kill is LASTIN with ciLASTATIN)
|
|
side effects of carbapenems
|
seizures, GI distress, rash
|
|
vancomycin - mechanism of action?
- side effects? |
binds D-Ala-D-Ala on cell wall and blocks cell wall mucopeptide formation
- NOT many: Nephrotoxicity, Ototoxicity, Thrombophlebitis, red man syndrome |
|
what antibiotics block 30S and 50S ribosomal subunits?
|
buy AT 30, CCELL at 50:
30S: Aminoglycosides, Tetracyclines 50S: Chloramphenicol, Clindamycin, Erythromycin, Lincomycin, Linezolid |
|
name 5 aminoglycosides
- mechanism of action? - anaerobe coverage? - side effects? |
mean GNATS: Gentamycin, Neomycin, Amikacin, Tobramycin, Streptomycin
- inhibit formation of 30S initiation complex - no anaerobe coverage - canNOT kill anaerobes: Nephrotoxicity, Ototoxicity, Teratogen |
|
uses of demeclocycline
|
antibiotic
ADH antagonist (Demeclocycline = Diuretic in SIADH) |
|
tetracyclines - mechanism of action?
- what are they used for? - side effects? |
block attachment of aminoacyl-tRNA to 30S
- VACUUM THe BedRoom: Vibro cholerae, Acne, Chlamydia, Ureaplasma Urealyticum, Mycoplasma pneumoniae, Tularemia, H. pylori, Borrelia burgdorferi, Rickettsia - discolor teeth and inhibit bone growth, photosensitivity |
|
which tetracycline can be used in patients with renal failure? why?
|
doxycycline - fecally eliminated
|
|
chloramphenicol - mechanism of action?
- use? - side effects? |
blocks 50S peptidyltransferase activity
- meningitis - aplastic anemia, gray baby syndrome |
|
what two drugs are mainly used to treat anaerobes, and where?
|
clindamycin - for anaerobes above the diaphragm
metronidazole - for anaerobes below the diaphragm |
|
clindamycin - mechanism of action?
- use? - side effect? |
blocks 50S peptide bond formation
- anaerobes - pseudomembranous colitis |
|
sulfonamides - mechanism of action?
- side effects? |
inhibit dihydropteroate synthetase (involved in folate synthesis)
- hemolysis in G6PD deficiency, nephrotoxicity, photosensitivity |
|
trimethoprim - mechanism of action?
- side effect? how can it be alleviated? |
inhibits dihydrofolate reductase (folate synthesis)
- bone marrow suppression (TMP = Treats Marrow Poorly) - alleviate with folinic acid |
|
fluoroquinolones - mechanism of action?
- side effects? |
inhibit DNA gyrase
- damage to cartilage, tendonitis, tendon rupture (fluoroquinoLONES hurt attachments to your BONES) |
|
what bacteria are treated with metronidazole?
- side effects? |
GET GAP on the metro:
Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes, H. Pylori - disulfiram-like reaction with alcohol, metallic taste |
|
polymyxins - mechanism of action?
- side effects? |
act like detergents - bind and disrupt cell membranes of bacteria ('MYXins MIX up membranes)
- neurotoxicity, acute renal tubular necrosis |
|
solo prophylaxis against M. tuberculosis
|
isoniazid
|
|
anti-TB drugs
- side effect for all? - side effect of ethambutol? |
INH-SPIRE: Streptomycin, Pyrazinamide, Isoniazid, Rifampin, Ethambutol
- hepatotoxicity - ethambutol causes red-green color blindness |
|
isoniazid - mechanism of action?
- side effects? |
blocks synthesis of mycolic acids
- neurotoxicity, hepatotoxicity (INH Injures Neurons and Hepatocytes) |
|
rifampin - mechanism of action?
- side effects? |
4 R's:
RNA polymerase inhibitor Revs up microsomal P-450 Red/orange body fluids Rapid resistance if used alone |
|
treatment of MRSA
|
vancomycin
|
|
treatment of vancomycin-resistant enterococcus
|
linezolid and streptogramins (quinupristin/dalfopristin)
|
|
amphotericin B - mechanism of action?
- side effects? |
binds ergosterol and forms membrane pores (amphotericin "tears" holes in the membrane)
- fever/chills, nephrotoxicity, arrhythmias, anemia, IV phlebitis |
|
nystatin - mechanism of action?
|
binds ergosterol and disrupts fungal membranes
|
|
azoles - mechanism of action?
- side effects? |
inhibit fungal ergosterol synthesis
- gynecomastia, inhibit cytochrome P-450 |
|
what drug is used to treat cryptococcal meningitis? why?
|
fluconazole - can cross blood-brain barrier
|
|
flucytosine - mechanism of action?
- use? - side effect? |
blocks DNA synthesis
- systemic fungal infections - bone marrow suppression |
|
caspofungin - mechanism of action?
|
blocks synthesis of beta-glucan (part of fungal cell wall)
|
|
terbinafine - mechanism of action?
|
inhibits fungal squalene epoxidase (part of ergosterol synthesis)
|
|
griseofulvin - mechanism of action?
|
blocks mitosis by interfering with microtubule function
|
|
amantadine - mechanism of action?
- used to treat? - side effects? |
blocks viral uncoating (a man to dine takes off his coat), increases dopamine release
- Amantadine - used to treat influenza A and rubellA and Parkinson's - ataxia, slurred speech (causes problems with the cerebellA) |
|
zanamavir/oseltamavir - mechanism of action?
|
inhibit influenza neuraminidase
|
|
ribavirin - mechanism of action?
- used for? - side effect? |
inhibits IMP dehydrogenase (blocks nucleotide synthesis)
- RSV, chronic hepatitis C - hemolytic anemia |
|
acyclovir - mechanism of action?
- used for? |
GTP analog - inhibits viral DNA polymerase
- HSV, VZV, EBV |
|
ganciclovir - mechanism of action?
- used for? - side effects? |
GTP analog - inhibits viral DNA polymerase
- CMV - leukopenia, neutropenia, thrombocytopenia |
|
foscarnet - mechanism of action?
- how is it unlike acyclovir and ganciclovir? - side effect? |
pyrophosphate analog (FOScarnet = pyroFOSphate analot) - viral DNA polymerase inhibitor
- does not need to be activated by viral kinase to work - nephrotoxic |
|
what class of drugs are saquinavir, ritonavir, indinavir, etc.?
- side effects? |
HIV protease inhibitors (NAVIR TEASE a proTEASE)
- hyperglycemia, lipodystrophy |
|
what class of drugs are zidovudine, didanosine, zalcitabine, stavudine, etc.?
|
HIV nucleoside reverse transcriptase inhibitors (have you dined/vudine with my nuclear/nucleoside family?)
|
|
name 3 HIV non-nucleoside reverse transcriptase inhibitors
|
Never Ever Deliver nucleosides:
Nevirapine Efavirenz Delavirdine |
|
side effects of HIV reverse transcriptase inhibitors
|
bone marrow suppression, peripheral neuropathy, lactic acidosis, rash, megaloblastic anemia
|
|
name an HIV fusion inhibitor
- mechanism of action? |
enfuvirtide - binds viral gp41 and blocks conformational change necessary for fusion with CD4
|
|
antibiotics to avoid in pregnancy
|
SAFE Moms Take Really Good Care:
Sulfonamides Aminoglycosides Fluoroquinolones Erythromycin Metronidazole Tetracyclines Ribavirin Griseofulvin Chloramphenicol |
|
where do T cells and B cells mature?
|
T cells = Thymus
B cells = Bone marrow |
|
what HLA genes encode MHC I?
- MHC II? |
MHC I - A, B, C (HLA I letter)
MHC II - DR, DP, DQ (HLA II letters) |
|
location of MHC I vs. II
|
MHC I - on all nucleated cells
MHC II - only on APCs |
|
cytotoxic vs. helper T cells - which has CD4 and which has CD8?
- which MHC class do they each bind to? |
cytotoxic T cells - CD8 (binds MHC I)
helper T cells - CD4 (binds MHC II) (product of CD and MHC = 8) |
|
what are the 2 signals needed for Th cell activation?
|
1. MHC II presents antigen to TCR
2. B7 on APC binds CD28 on T cell |
|
what are the 2 signals needed for Tc cell activation?
|
1. MHC I presents antigen to TCR
2. IL-2 from Th cell signals Tc cell to kill |
|
what are the 2 signals needed for B cell class switching?
|
1. IL-4, IL-5, or IL-6 from Th2 cell
2. CD40 receptor on B cell binds CD40 ligand on Th cell |
|
characteristics of Fc portion of antibody
|
Constant
Carboxy terminal of heavy chain Complement-binding area Carbohydrate side chains |
|
3 functions of antibodies
|
1. opsonization
2. neutralization 3. complement activation (enhances opsonization and lysis of antigen) |
|
which immunoglobulin is found in mucous membrane secretions?
|
IgA
|
|
which immunoglobulin can be a dimer?
- which a pentamer? |
dimer: IgA
pentamer: IgM |
|
which immunoglobulin mediates type I hypersensitivity?
|
IgE
|
|
what is an Ig allotype?
- isotype? - idiotype? |
allotype - epitope that differs among members of the same species (ALLotypes = different ALLeles)
isotype - epitope common to a single class of Ig idiotype - epitope determined by antigen-binding site |
|
what is a thymus-independent antigen?
- what type of Ig is secreted in response? |
no peptide component
- IgM only (can't be presented on MHC to T cells, so no T cell activation of B cells for class switching) |
|
what are the functions of IL-1-5?
|
hot T-Bone stEAk:
IL-1 - inflammatory response, fever (hot) IL-2 - stimulates T cells IL-3 - stimulates Bone marrow IL-4 - stimulates IgE production IL-5 - stimulates IgA production |
|
what is the function of IL-8?
- what is it secreted by? |
recruits neutrophils to clear infections (clean up on aisle 8)
- secreted by macrophages |
|
what activates the classic complement pathway?
|
IgG or IgM (GM makes classic cars)
|
|
what is the function of decay-accelerating factor (DAF) and C1 esterase inhibitor?
- what does deficiency of each cause? |
prevent complement activation on self-cells
- deficiency of C1 esterase inhibitor - hereditary angioedema - deficiency of DAF - paroxysmal nocturnal hemoglobinuria (complement-mediated lysis of RBCs) |
|
what is the function of C3b?
|
opsonization (C3b Binds Bacteria)
|
|
what is the function of C3a and C5a?
|
C3a, C5a - Anaphylaxis
|
|
what does deficiency of C5-C8 predispose to?
|
Neisseria bacteremia
|
|
what are the functions of interferons?
|
interferons interfere with virus activity in uninfected cells:
- alpha- and beta-interferons cause production of viral protein-inhibiting ribonuclease - gamma-interferons stimulate MHC I and II expression - also activate NK cells |
|
with what infections are patients given preformed antibodies (passive immunity)?
|
given antibodies To Be Healed Rapidly:
Tetanus toxin Botulinum toxin HBV Rabies virus |
|
what cytokine plays a major role in granulomas?
- what secretes it? - what does it do? |
IFN-gamma
- secreted by Th1 cells - stimulates macrophages |
|
what are the 4 types of hypersensitivity reactions?
|
ACID:
I - Anaphylactic and Atopic II - Cytotoxic (antibody-mediated) III - Immune complex IV - Delayed (cell-mediated) |
|
what is serum sickness?
- what type of hypersensitivity reaction? - how is the Arthus reaction different? |
antibodies to foreign serum protein or drug form - immune complexes deposit in tissues and fix complement - tissue damage
- type III hypersensitivity - Arthus reaction - local intradermal injection of antigen, so complexes formed locally in skin |
|
what initiates type IV hypersensitivity reactions?
- give 3 examples |
4 T's:
T lymphocytes - Transplant rejections, TB skin tests, Touching (contact dermatitis) |
|
what is the defect in Bruton's agammaglobulinemia?
- what is the major symptom? - what is the inheritance pattern? |
defect in tyrosine kinase gene - causes decreased production of B cells
- recurrent Bacterial infections after maternal IgG levels decline - X-linked recessive (affects Boys) |
|
what is the defect in severe combined immunodeficiency?
|
defect in early stem-cell differentiation - decreased production of B and T cells
|
|
what causes hyper-IgM syndrome?
|
defect in CD40 ligand on Th2 cells - inability to class switch
|
|
what is the defect in Wiskott-Aldrich syndrome?
- what are the main symptoms? |
defect in ability to mount IgM response - low IgM, high IgE and IgA (Aldrich)
- WIPE: recurrent Infections, thrombocytopenic Purpura, Eczema |
|
what is the defect in Job's syndrome?
- symptoms? |
failure of IFN-gamma production, so no neutrophil chemotaxis
- FATED: coarse Facies, cold staphylococcal Abscesses, retained primary Teeth, increased IgE, Dermatologic problems |
|
what is the defect in Chediak-Higashi syndrome?
|
defect in microtubule function and thus lysosomal emptying of phagocytic cells
|
|
what is the defect in chronic granulomatous disease?
|
lack of NADPH oxidase - defect in microbicidal activity of neutrophils
|
|
what is the defect in chronic mucocutaneous candidiasis?
|
T-cell dysfunction, specifically against Candida albicans
|
|
what is the defect in ataxia-telangiectasia?
|
defect in DNA repair enzymes with associated IgA deficiency
|
|
what is the defect in common variable immunodeficiency?
|
defect in B cell maturation - normal number of circulating B cells, but decreased plasma cells
|
|
what diseases are associated with HLA-B27?
|
PAIR:
Psoriasis Ankylosing spondylitis Inflammatory bowel disease Reiter's syndrome |
|
cyclosporine - mechanism of action?
- side effects? |
inhibits calcineurin, preventing production of IL-2 (blocks T cell activation)
- susceptibility to infection, nephrotoxic |
|
tacrolimus - mechanism of action?
- side effects? |
binds FK-binding protein, inhibiting IL-2 secretion (blocks T cell activation)
- nephrotoxic, peripheral neuropathy |
|
azathioprine - mechanism of action?
- side effects? - what is the effect of simultaneous allopurinol? |
blocks nucleic acid synthesis - toxic to proliferating lymphocytes
- bone marrow suppression - increased toxicity (since drug is metabolized by xanthine oxidase) |
|
muromonab - mechanism of action?
|
binds CD3 on T cell surface and blocks T cell signal transduction
|
|
sirolimus - mechanism of action?
- side effects? |
binds mTOR and blocks T cell proliferation in response to IL-2
- hyperlipidemia, thrombocytopenia, leukopenia |
|
mycophenolate mofetil - mechanism of action?
|
inhibits de novo guanine synthesis - blocks lymphocyte production
|
|
daclizumab - mechanism of action?
|
binds IL-2 receptor on activated T cells
|
|
loading dose equation
- maintenance dose equation |
loading = Cp x Vd/F
maintenance = Cp x Cl/F |
|
name 3 zero-order elimination drugs
|
PEA (pea is round, like 0):
Phenytoin Ethanol Aspirin |
|
therapeutic index equation
|
TILE:
TI = LD50/ED50 (LD50 = median lethal dose, ED50 = median effective dose) |
|
what G-protein class is associated with each receptor type?
|
qiss and qiq till you're siq of sqs:
qiss = alpha1, alpha2, beta1, beta2 qiq = M1, M2, M3 siq = D1, D2, H1 sqs = H2, V1, V2 |
|
bethanechol - mechanism of action?
- used for? |
muscarinic agonist
- used for postoperative ileus and urinary retention - activates Bowel and Bladder smooth muscle (Beth Anne, call me if you want to activate your Bowels and Bladder) |
|
pilocarpine - mechanism of action?
- used for? |
muscarinic agonist
- stimulates sweat, tears, saliva (PILocarpine - PILE on the sweat and tears) |
|
methacholine - mechanism of action?
- used for? |
muscarinic agonist
- challenge test for diagnosing asthma (bronchoconstricts) |
|
neostigmine and pyridostigmine - mechanism of action?
- used for? - CNS penetration? |
anticholinesterases
- myasthenia gravis - NO CNS penetration (NEO CNS) |
|
physostigmine - mechanism of action?
- used for? |
anticholinesterase
- glaucoma (PHYS is for EYES) |
|
echothiophate - mechanism of action?
- used for? |
anticholinesterase
- glaucoma |
|
symptoms of cholinesterase inhibitor poisoning
- what is the antidote? |
DUMBBELSS:
Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, Salivation - antidote: atropine + pralidoxime (regenerates cholinesterase) |
|
benztropine - mechanism of action?
- used for? |
muscarinic antagonist
- PARKinson's disease (PARK my BENZ) |
|
scopolamine - mechanism of action?
- used for? |
muscarinic antagonist
- motion sickness |
|
ipratropium - mechanism of action?
- used for? |
muscarinic antagonist
- asthma, COPD (I pray/ipra- I can breathe soon) |
|
oxybutynin, glycopyrrolate - mechanism of action?
- used for? |
muscarinic antagonists
- reduce bladder urgency/spasms |
|
methscopolamine, pirenzepine, propantheline - mechanism of action?
- used for? |
muscarinic antagonists
- peptic ulcer treatment |
|
atropine - mechanism of action?
- side effects? |
muscarinic antagonist
- hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter |
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hexamethonium - mechanism of action?
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nicotinic antagonist (put a HEX on smokers/nicotine) - ganglionic blocker
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what are low doses of epinephrine selective for?
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beta1 receptors (Blow - low = beta1)
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what is norepinephrine selective for?
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alpha > beta1 (NO beta2 activity)
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what is isoproterenol selective for?
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beta receptors only
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dobutamine - mechanism of action?
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beta1 agonist
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