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Test 16 Flashcards

1
Q

Why do hepatitis C antibodies NOT confer effective immunity against the infection?

A

There’s a large variety in hep C virus envelop proteins, so the host Abs always lag behind the production of new mutant strains of HCV making it REALLY hard to confer immunity.

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2
Q

A 34 y/o immigrant presents w/ patchy areas of skin anesthesia and hypopigmentation on his upper extremities. Nerve biopsy shows bacteria invading SCHWANN cells.

A

Myobacterium leprae

grows best at temps slightly lower than body temp so it commonly effects extremities

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3
Q

What limits tuberculoid leprosy?

A

Least severe form

Limited by intact cell mediated immune system

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4
Q

In what type of pts does lepromatous leprosy occur in?

A

pts w/ a weak cell mediated Th1 immune response–mphages are nevere given the signal to kill myobacterial organisms so it disseminates (lionized facies)

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5
Q

What spirochete is responsible for Lyme disease?

A

Borrelia burgdorferi

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6
Q

What spirochete is responsible for syphilis?

A

Treponema pallidum

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7
Q

Describe the progression of syphilis.

A

Painless chancre> diffuse eruption of erythematous macules (palms and soles) and formation of conyloma lata> gummas of skin and bone, aortitis, neurosyphilis

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8
Q

What gram - rod causes mild enteritis in immunocompetent pts and mild systemic bacteremic illness in immunocompromised pts?

A

Campylobacter fetus

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9
Q

A 64 yearl old man loses consciousness b/c of low bp while buttoning his tight collar shirt. What afferent nerves are responsible for this?

A

External pressure on the carotid sinus of the internal carotid area stimulates baroreceptors in the carotid sinus walls>
CN 9>
vasodilation, decrease in heart rate/contractility/decrease in bp

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10
Q

Where do fibers from both the carotid sinuses and aortic arch baroreceptors terminate?

A

Both CN 9 and CN 10 terminate on the solitary nucleus of the medulla

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11
Q

What lies immediately deep to the tip of the 12th rib on the left?

A

kidney

11/12th ribs are floating ribs–the distal tip fo the 12th rib can be displaced into the retroperitoneum when fractured and LACERATE the kidney

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12
Q

lies under the 9th, 10th, 11th ribs

A

spleen

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13
Q

lies under the 8, 9, 10, 11 rib

A

liver

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14
Q

fractures of 1st through 6th ribs may damage…

A

visceral pleura

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15
Q

What type of trauma causes pancreatic damage?

A

crushing abdominal damage

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16
Q

What method is used in designing case-control studies to control for confounding?

A

Matching: Selecting variables that could be confounders (age, race), so that there is a similar distribution

Cases (pt’s w/ CRC) are matched w/ controls (neighbors) of similar age and race–also accounts for socioeconomic status/environmental factors

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17
Q

What is a confounding variable?

A

A factor related to BOTH the exposure and the outcome but NOT the casual pathway

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18
Q

Lactic acidosis

Raged red skeletal muscle fibers

A

Mitochondrial myopathy

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19
Q

Heteroplasmy

A

Coexistence of both mutated and WT versions of mitochondrial genomes in an individual cell> variable expression in a mitochondrial related disease

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20
Q

All invdividuals with a given gene express its phenotype

A

full penetrance

21
Q

Presence of genetically distinct cell lines in the same individual

A

mosaicism

22
Q

A pt has a mutation that affects G protein signaling and presents w/ unilateral cafe-au lait spots, polyostotic fibrous dysplasia, precocious puberty and multiple endocrine abnormalities.

A

McCune Albright Syndrome

23
Q

Both members of a given pair of nuclear chromosomes are inherited from the same parent

A

Uniparental disomy

24
Q

Bounding femoral pulses and carotid pulses accompanied by head bobbing

A

Water hammer pulses w/ each heart beat are signs of aortic regurgitation d/t LARGE LV stroke volume

25
Q

What is the major determinant of the degree of R to L intracardiac shunting, and thus the severity of the hypoxemic sx, in pts with TOF?

A

RF outflow obstruction (pulmonary stenosis)

26
Q

What characterizes TOF?

A

pulmonary stenosis
VSD
RVH
over riding aorta (straddles VSD)

27
Q

What happens to PTH, calcitonin and vit D in resopnse to Ca loading?

A

PTH and Vit D decrease (increase in Ca NFB)

Calcitonin increases (sequester excess Ca)

28
Q

Polycythemia Vera, essential thrombocytosis and primary myelofibrosis are all examples of..

A

Chronic myeloproliferative disorders

29
Q

Mutation in V617F affecting JAK 2 (cytoplsmic TK) leading to constitutive TK activity> cytokine independent activation of STAT TF

A

Chronic MP disorders

30
Q

Easy bruising, microangiopathic occlusion, THROMBOCYTOSIS (increased number of platelets) and megakaryocytic hyperplasia

A

Essential thrombocytosis

Over production of normal platelets> bleeding and thrombosis. Bone marrow contains enlarged megakaryocytes

31
Q

Pruritis, splenomegaly, thrombotic complications, ERYTHROCYTOSIS (increased number of RBC) and thryobocytosis

A

POlycythemia Vera

Itching after hot shower (d/t increase in basophils).

32
Q

Severe, burning pain and red blue coloration d/t episodic blood clots in vessels of extremities.

A

Polycyhtemia vera

33
Q

Severe fatigue, MASSIVE splenomegaly (causing early satiety/abdominal discomfort, hepatomegaly, anemia and BONE MARROW FIRBORIS

A

primary myelofibrosis

Obliteration of bone marrow d/t increased fibroblast activity in response to proliferation of monoclonal cells lines.

Tear drop and nucleated RBC

34
Q

What characterizes chronic MP disorders?

A

overproliferation of myeloid cells

35
Q

Philadelphia chromosome t(9:22) mutation BCR-ABL fusion protein

A

Chronic mylogenous leukemia

36
Q

Fatigue, weight loss, splenomegaly, LEUKOCYTOSIS W/ MARKED LEFT SHIFT (increased neutrophils, metamyelocytes, bsophils)

A

Chronic myelogoenous leukemia

37
Q

Fever, fatigue, pallor, petechiae and bleeding in children.

A

Acute lymphocytic leukemia

38
Q

T 15,17 leads to formation of fusion gene between PML and retinoic acid receptor alpha genes blocking differentiation of myeloid precursors.

A

Acute promyelocytic leukemia

responds to all-trans retinoic acid–Vit A

39
Q

Lymphoproliferative disorder involving B lymphocytes and smudge cells on peripheral blood smear.

A

Chronic lymphocytic leukemia

> 60

40
Q

8,14 translocation

c-myc oncogene

A

Burkitt Lymphoma (non-hodgkin)

41
Q

Microangiopathic hemolytic anemia (HUS), thrombocytopenia, and renal insufficiency after GI infection.

A

E. coli 0157:H7 in UNDERCOOKED GROUND BEEF causes HUS in children under

-shistocytes on blood smear, platelet consumption, decreased renal blood flow

42
Q

Custard, mayonnaise, salted meats

A

s. aureus

preformed toxin> watery nonbloody diarrhea

43
Q

Fried rice ingestion

A

Bacillus cereus

44
Q

Raw oysters

A 
vibrio parahaemolyticus (voluminous water diarrhea, like cholera)
vibrio vulnificus
45
Q

Raw egg, raw chicken consumption and improper food handling

A

salmonella

46
Q

Canned beans/jarred food

A

c. botulinum

47
Q

Maxillary prominences fail to fuse w/ intermaxillary segment during early development

A

cleft lip

48
Q

palatine shelves of maxillary prominence fail to fuse w/ one another or primary palate

A

cleft palate

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