4/1 micro Flashcards
1
Q
Giardia lamblia
-how does it cause steattorhea?
A
- inflammation and villous atrophy of the small bowel/gut.
- adheres to intestinal brush border and releases molecules that induce a mucosal inflammatory response.
- causes injury to duodenal and jejunal mucosa.
2
Q
Giardia lamblia
- major immune response against it?
- which pts at inc. risk?
A
- CD4 & IgA
- Bruton’s agamma, CVID, & IgA deficient pts
3
Q
Entamoeba histolytica
-what can it cause?
A
- bloody diarrhea, liver abscess (“anchovy paste”exudate)
- RUQ pain (histology shows flask-shaped ulcer if submucosal abscess of colon ruptures).
4
Q
Entamoeba histolytica: Dx:
- what will biopsy show?
- what will stool show?
A
- biopsy: trophozoites (with RBCs in the cytoplasm).
- stool: cysts (with up to 4 nuclei).
*also serology
5
Q
Entamoeba histolytica: Tx
- for symptomatic pts:
- for asymptomatic cyst passers:
A
- Metronidazole
- iodoquinol for asymptomatic cyst passers.
6
Q
Cryptosporidium
-how does it stain?
A
acid fast
7
Q
Cryptosporidium
-Tx:
A
- Prevention (by filtering city water supplies)
- nitazoxanide in immunocompetent hosts.
8
Q
nitazoxanide
-used for what?
A
To treat Cryptosporidium in immunocompromised hosts.
9
Q
Congenital toxoplasmosis
- classic triad:
- mnemonic:
A
- CHIC
- Chorioretinitis, Hydrocephalus, Intracraniel Calcification.
10
Q
Choroid of eye
-what is it?
A
The vascular layer of the eye, containing connective tissue, and lying between the retina and the sclera.
11
Q
toxoplasmosis
-how to Dx?
A
-Serology, biopsy (tachyzoite).
12
Q
toxoplasmosis
-Tx:
A
Sulfadiazine + pyrimethamine
13
Q
Congenital toxoplasmosis
-how will baby present?
A
-pregnant pts, baby can have hydrocephaly, progressive blindness. Also, baby can be born asymptomatic but by their late teenage years, can start to lose vision.
14
Q
Cryptosporidium & T. gondii
-what is our defense against them?
A
They’re intracellular, so CD8.
15
Q
Naegleria fowleri
- Dx:
- Tx:
A
- Amoebas in spinal fluid.
- Amphotericin B - although most pts die.
16
Q
Trypanosoma brucei
-what does it cause?
A
African sleeping sickness: enlarged lymph nodes, recurring fever (due to antigenic variation), somnolence, coma.
17
Q
Trypanosoma brucei
- transmission?
- how is its vector different than chagas?
A
- Tsetse fly, a painful bite.
- Chagas caused by reduvid bug = painless bite.
18
Q
Trypanosoma brucei
- Tx:
- menmonic:
A
“it SURe is nice to go to sleep”; MELAtonin helps w/ sleep”.
- SURamin for blood-borne disease.
- MELArsoprol for CNS penetration
19
Q
P. vivax/ovale
- fever pattern? aka?
- Tx for dormant form?
A
- 48 hrs = tertian.
- dormant form (hypnozoite) in liver = give primaquine.
*test for G6PD def. before starting primaquine.
20
Q
P. falciparum
- fever pattern?
- besides fevers, what can it cause?
A
- irregular fever pattern.
- parasitized RBCs occlude capillaries in brain (cerebral malaria), kidneys, lungs.
21
Q
P. malariae
-fever pattern? aka?
A
-72-hr cycle (quartan).
22
Q
Malaria
-Dx:
A
Blood smear:
- trophozoite ring form within RBC.
- schizont containing merozoites.
23
Q
chloroquine
-how does it treat malaria?
A
Blocks Plasmodium heme polymerase.
24
Q
Malaria
- 1st line Tx:
- what if their resistant to first line:
A
- begin with chloroquine.
- if resistant, use mefloquine or atovaquone/proguanil.
25
Malaria
| -if life threatening: treat w/what?
-use IV quinidine (test for G6PD deficiency).
26
Vivax/ovale
| -what do you have to add to the Tx?
-add primaquine for hypnozoite (test for G6PD deficiency).
27
Babesia
| -what will blood smear show?
Blood smear, ring form, “Maltese cross”.
28
Babesia
| -Tx:
Atovaquone + azithromycin.
29
Babesia
| -mnemonic:
Tetrad = think meiosis = think baby = think babesiosis
Babies are carried in mother = think of coinfection w/Borrelia
-I want an AA baby = atovaquone + azithromycin
30
Trypanosoma cruzi
| -mnemonic:
Tom Cruise (Cruzi) is a huge ass (megacolon), who is pretty hard to swallow (megaesophagus/achalasia), but he has a big heart (dilated cardiomyopathy) and he knows how to kiss red lips" (transmitted by Reduvid bug, aka kissing bug).
31
Chagas disease:
- which bug?
- what does it cause?
- trypanosoma cruzi
| - dilated cardiomyopathy, megacolon, megaesophagus/achalasia; predominantly in South America.
32
Chagas diease
- common early sign?
- what type of heart condition can it cause?
- periorbital swelling = common early sign of chagas.
| - dilated cardiomyopathy
33
Chagas diease
| -Tx:
Tom cruise drives a "benz" and gets Nifer botOX.
| -Benznidazole or nifurtimox.
34
Leishmania donovani
- Sxs:
- mnemonic:
- donovan frankenreiter -> big drinker, big liver and spleen.
- spiking fevers, pancytopenia.
35
Leishmania donovani
- Tx:
- mnemonic:
-donovan gets a lot of ASS = Amphotericin b, Sodium Stibogluc.
36
Leishmania donovani
- vector:
- mnemonic:
-donovan lives on beach = sand = sandfly
37
Leishmania donovani
| -what two forms of disease can it cause?
- Visceral infection - MASSIVE splenomegaly.
| - Cutaneous infection: ulcerating skin sore at site of the bite. Most will heal spontaneously over a year.
38
Trichomonas vaginalis
- vaginitis or vaginosis?
- color of discharge?
- itching/burning?
- vaginitis
- greenish discharge
- yes
39
Trichomonas vaginalis
- how is the cervix described?
- Tx:
- Strawberry cervix.
| - Metronidazole for patient and partner (prophylaxis).
40
Intestinal Nematode
- aka?
- mnemonic?
- Intestinal roundworms
| - nematodes are NASA-E (nasty).
41
Intestinal Nematodes
- name them
- mnemonic
- nematodes are NASA-E (nasty).
- Necator americanus
- Ancylostoma duodenate
- Strongyloides stercoralis
- Ascaris lumbricoides
- Enterobius vermicularis
42
Intestinal Nematodes
- Tx? mnemonic?
- exception?
Worms BEND, BEND them enough and they break(die).
Bendazoles + pyrantel pamoate
-except strongyloides = ivermectin.
43
Tissue nematodes
- aka?
- mnemonic?
- tissue roundworms
| - TOWL
44
Tissue nematodes
- name them
- mnemonic
TOWL
- toxocara canis
- onchocerca volvulus
- wucheria bancrofti
- Loa Loa
45
Cestodes
- aka?
- menmonic?
- tapeworms
| - TED's tape
46
Cestodes
- name them
- mnemonic
TED's tape
- Taenia saginatum/solium
- Echinococcus graunlosis
- Diphyllobothrium latum
47
Cestodes + trematodes
- Tx?
- exception:
- praziquantel
| - except echinococcus granulosis = albendazole.
48
Trematodes
- aka? aka?
- mnemonic?
- flukes = flatworms
| - SS fluke
49
Trematodes
- name them
- mnemonic
SS fluke
- schistosoma
- clonorchis sinensis
50
Enterobius vermicularis
- aka?
- menmonic:
- Tx:
- pinworm
- verm = worm, aris = anus.
- the scotch tape worm.
- Tx: bendazole or pyrantel pamoate.
51
Ascaris lumbricoides
- aka
- connection w/intermitten RUQ pain?
- Tx:
- giant roundworm
- can invade biliary tree & lead to brown pigment stones.
- Tx: bendazole or pyrantel pamoate.
52
Strongyloides stercoralis
- transmission?
- what kind of pain can it cause?
- Tx:
- Larvae in soil penetrate the skin.
- PUD-like epigastric pain.
- Tx: ivermectin or albendazole.
- can also cause pneumonia during their path to the intestines.
53
How do larvae that penetrate your skin make it to your GI tract?
- Infectious (filariform) larvae penetrate the skin of feet, enter bloodstream, & transported to lungs. The larvae enter alveoli & ascend toward trachea, causing respiratory tract inflammation (can manifest as pneumonia).
- Larvae pass from the trachea to pharynx, & when swallowed the larvae mature into adults in s. intestines to attach to the mucosa.
- Initially causes gastroenteritis, but secretion of anticoagulant and consumption of blood results in anemia.
- Adults mate in the lumen of the intestine, allowing eggs to be shed in the feces.
54
immune response against invasive helminths?
Eonsinophils
55
Invasive intestinal helminths:
| -what kind of immune response?
- invasive ones = strongyloides, ancylostoma, necator.
| - eosinophillic response.
56
Ancylostoma duodenale, Necator americanus
- aka?
- transmission?
- main Sx?
- hookworms
- Larvae penetrate skin.
- microcytic anemia, they suck your blood.
- can also cause pneumonia during their path to the intestines.
57
Ancylostoma duodenale, Necator americanus
| -Tx:
-bendazoles or pyrantel pamoate.
58
Onchocerca volvulus
- what class?
- transmission?
- mnemonic?
- tissue nematode
- Female blackfly bite
- "ochocinco" is black = blackfly bite, black skin nodules, “black sight”. He does NOT swim in the river!
59
Onchocerca volvulus
- Tx:
- mnemonic:
-Ivermectin (ivermectin for river blindness).
60
river blindness
| -cause?
Onchocerca volvulus
61
Loa loa
- what class?
- transmission?
- tissue nematode.
| - Deer fly, horse fly, mango fly.
62
Loa loa
| -what it cause?
Swelling in skin, worm in conjunctiva.
| -does NOT cause blindness.
63
Onchocerca volvulus vs Loa loa
| -which one can cause blindness?
Onchocerca volvulus.
64
Loa loa & Wuchereria bancrofti
| -Tx:
Diethylcarbamazine
65
Diethylcarbamazine
| -what is it?
Tx for Loa loa & Wuchereria bancrofti.
66
Nematodes
- Ingested:
- mnemonic:
You’ll get sick if you EAT these!
| -Enterobius, Ascaris, Toxocara
67
Nematodes
| -cutaneous:
These get into your feet from the SANd.
| -Strongyloides, Ancylostoma, Necator.
68
Nematodes
| -Bite:
Lay LOW to avoid getting bitten.
| -Loa loa, Onchocerca volvulus, Wuchereria bancrofti.
69
Taenia solium
- what class?
- aka?
- Tapeworm = cestode
| - pork tapeworm.
70
Taenia solium
- What do you consume to become definitive host?
- what do you consume to become intermediate host?
- larvae from pork => definitive host.
| - eggs from fecal-oral => intermediate.
71
Taenia solium:
- definitive host => which Sxs
- intermediate host => which Sxs
- definitive host => intestinal infection + poop out eggs.
| - intermediate host => cysticercosis/neurocysticercosis.
72
Taenia solium
- Tx for intestinal infection:
- Tx for neurocysticercosis:
- praziquantel for intestinal
| - albendazole for neurocysticercosis
73
Diphyllobothrium latum
- what class?
- aka?
- cestode = tapeworm.
| - fish tapeworm.
74
Diphyllobothrium latum
| -transmission?
Ingestion of larvae from raw freshwater fish.
75
Diphyllobothrium latum
- what it cause?
- Tx:
-Vitamin B12 deficiency (tapeworm competes for B12
in intestine) => megaloblastic anemia.
-praziquantel.
76
Echinococcus granulosus
- whats the definitive host?
- whats the intermediate host?
- Definitive host = dog
| - Intermediate hosts = sheep & human.
77
Eat larvae you become which type of host?
definitive host
| -larvae can mature into adults.
78
Eat eggs you become which type of host?
intermediate host
| -eggs can hatch into larvae, but larvae can not mature into adults.
79
Echinococcus granulosus
- what class?
- how do you get it?
- will you be definitive or intermediate host?
- cestodes = tapeworm
- Ingestion of eggs from dog feces.
- intermediate host.
80
Echinococcus granulosus
- Sxs:
- Tx:
-Hydatid cysts in liver, causing anaphylaxis if antigens
released (surgeons preinject with ethanol to kill cysts
before removal).
-albendazole.
81
trematode
| -aka? aka?
-fluke, flatworm.
82
Cestodes
| -what do you usually find in stool?
Find proglottids in stool.
83
Trematodes
| -what do you usually find in stool?
Eggs
84
Schistosoma
- what class?
- what is the host?
- transmission?
- trematode = fluke = flatworm.
- snails = intermediate host.
- cercariae penetrate skin of humans.
85
Schistosoma
| -what does it cause?
-Liver and spleen granulomas, fibrosis, and inflammation.
*Chronic infection with S. haematobium can lead to
SCC of the bladder (painless hematuria).
86
Schistosoma
| -which species can lead to which type of cancer?
Chronic infection with S. haematobium can lead to SCC of the bladder (painless hematuria).
*HEMAtobium can cause painless HEMAturia.
87
Schistosoma manSoni vs hemaTobium
| -difference in appearance?
- mansoni has a sub-terminal spine.
| - hematobium has a terminal spine.
88
Schistosoma
| -how to Dx?
Find eggs in stool.
89
Clonorchis sinensis
- what class?
- aka?
- how do you get it?
- Trematode = fluke = flatworm.
- Chinese Liver fluke.
- Undercooked fish
*dont confuse w/ochocirca thats River blindness.
90
Clonorchis sinensis
| -mnemonic:
-Clo = "Col" = cholangiocarcinoma. SIN = one of seven
deadly sins is gluttony, and you need a gallbladder
to digest all that fat.
91
Clonorchis sinensis
| -what can it cause?
- Biliary tract inflammation => pigmented gallstones.
| - Associated with cholangiocarcinoma.
92
Clonorchis sinensis
| -how does it cause brown pigment stones?
Can invade biliary tree & lead to inc. in beta-glucoronidase which unconjugates bili = brown pigment stones.
93
Clonorchis sinensis
| -whats unique about its egg?
The egg has an operculum aka a lid.
94
Clonorchis sinensis
| -Tx:
praziquantel.
95
Which helminths can cause microcytic anemia?
- Ancylostoma duodenale, Necator americanus
| (hookworms) .
96
How do naked viruses exit their host cell?
They lyse the cell. If they blebbed off, then they would be enveloped.
97
What does "naked" virus mean?
- does it have envelope?
- does it have capsid?
- naked = no envelope (lipid bilayer).
| - yes, it can still have a capsid.
98
What are the two types of capsids?
Icosahedral and helical.
99
Helical capsid viruses
| -what do they all have in common?
There are no naked viruses w/a helical capsid.
| -so all viruses w/helical capsules have envelopes.
100
If a virus is can get past the stomach acidity, what characteristic must it have?
Must be a naked virus!
| -so by definition it can NOT have a helical capsid!
101
Viral capsids
| -what are they made of?
Protein
102
Location of envelope w/relation to viral capsid:
the envelope is OUTSIDE of the capsid.
| -makes sense b/c when a virus blebs off, takes envelope w/it, so envelope must be the outer most layer.
103
Recombination
| -define:
Exchange of genes between 2 chromosomes by crossing over within regions of significant base
sequence homology.
104
Reassortment
| -happens in what kind of viruses?
Those w/segmented genomes: BOAReo
| -bunya, orthomyxo, arena, reovirus.
105
Viral Complementation
| -define:
When 1 of 2 viruses that infect the cell has a mutation that results in a nonfunctional protein. The nonmutated virus “complements” the mutated one by making a functional protein that serves both viruses.
106
Viral: Phenotypic mixing
| -define:
-Occurs with simultaneous infection of a cell with 2 viruses.
-Genome of virus A can be partially or completely coated (forming pseudovirion) with the surface proteins of virus B.
-Type B protein coat determines the tropism (infectivity) of the hybrid virus. However, the progeny from this
infection have a type A coat that is encoded by its type A genetic material.
107
Live attenuated vaccines
- do you need boosters?
- mnemonic?
```
-no booster needed.
MIS SYC Live!
M=MMR
I=influenza (intranasal)
S=Sabin polio
S=smallpox
Y=yellow fever
C=chickenpox
```
108
Killed vaccines
| -mnemonic?
RIP Always.
- Rabies
- Influenza (injected)
- Salk Polio
- HAV vaccines.
109
Infleunza vaccine
| -which one is killed virus - injected or intranasal?
Injected = killed vaccine.
| -you wouldn't want to inject a live attenuated (no real reason, just a mnemonic).
110
Recombinant vaccines: name them
- HBV (antigen = recombinant HBsAg)
| - HPV (types 6, 11, 16, and 18).
111
DNA viruses
| -all = linear, except these, which circular:
papilloma-, polyoma-, and hepadnaviruses.
112
Only dsRNA virus:
Reovirus (rotavirus)
113
Positive-stranded RNA viruses:
| -mnemonic:
I went to a retro (retrovirus) toga (togavirus) party,
where I drank flavored (flavivirus) Corona (coronavirus) and ate hippy (hepevirus) California (calicivirus) pickles (picornavirus).
114
Negative strand RNA virus
| -what must it carry with it?
Is complementary to mRNAso needs to be converted to positive strand by RNA dep. RNA polymerase (they must carry gene for this b/c human cells dont have it).
115
Purified nucleic acids of most dsDNA and (+) strand ssRNA (≈ mRNA) viruses are infectious.
-exceptions:
-except poxviruses and HBV.
116
Are purified nucleic acids of (-) sense RNA viruses infectious?
No
| -they need the RNA-dep RNA pol. thats carried w/in the complete virion.
117
Viral replication: locations:
- DNA viruses:
- RNA viruses:
- DNA viruses = Replicate in the nucleus except poxvirus.
| - RNA viruses = Replicate in the cytoplasm (except influenza virus and retroviruses).
118
Which DNA viruses do NOT replicate in the nucleus?
poxvirus
| *carries own DNA-dependent RNA polymerase.
119
Which RNA viruses do NOT replicate in cytoplasm?
Influenza & retroviruses.
120
All enveloped viruses acquire their envelopes from plasma membrane of their host when they exit.
-except:
-herpesviruses, which acquire envelopes from
| nuclear membrane.
121
Naked viruses
| -mnemonic:
Give PAPP smears and CPR to a naked Heppy
- P = polyoma
- A = adeno
- P = papillo
- P = parvo
- C = calici
- P = picorna
- R = reo
- HepE
122
DNA viruses
| -mnemonic:
HHAPPPPy
- Hepadna
- Herpes
- Adeno
- Pox
- Parvo
- Papilloma
- Polyoma
123
hepadnavirus =
Hep B
124
All DNA viruses have what type of capsid?
| -except which one?
- All DNA = icosahedral
| - except poxvirus (poxvirus was also the one that didnt replicate in nucleus).
125
Poxvirus
| -how is it unique amongst the DNA viruses?
- does NOT replicate in nucleus.
| - does NOT have icosahedral capsid.
126
How are viruses taken into cells?
They are endocytosed.
| -they hook onto a surface receptor.
127
What protein allows herpesviridae to make multinucleated cells?
F protein.
128
common cause of spontaneous temporal lobe encephalitis?
| -what will you see on imaging?
HSV-1
| -hemorrhagic lesions in temporal lobe.
129
HHV-6
- what family of viruses?
- what disease does it cause?
- herpes virus
| - roseola (exanthem subitum)
130
HHV-7
- what family of viruses?
- what disease does it cause?
- herpes virus
| - less common cause of roseola
131
Hepadnavirus
- which hepatitis virus is this?
- genome made of?
- which unique enzyme does it have?
- hep B
- Partially DS and circular
- Not a retrovirus but has reverse transcriptase.
132
HepB lifecycle
| -order of genome events
circular partially dsDNA => dsDNA => mRNA + circular, partial dsDNA
133
swimming pool conjuctivitis
| -which virus?
adenovirus
134
Adenovirus
| -what diseases can it cause?
- Febrile pharyngitis—sore throat
- Acute hemorrhagic cystitis
- Pneumonia
- Conjunctivitis—“pink eye”
135
Parvovirus
| -Sxs in adults/
- Sx in adults: much more serious but rare b/c we usually get it as kids.
- Malaise, arthralgias, rash. These symptoms are caused by immune complex deposition aka TYPE 3 HSR.
136
Congenital B19
| -how does fetus die?
RBC destruction in fetus => hydrops fetalis.
137
Polyomavirus
- which two viruses in this family?
- mnemonic for what they cause:
"JC: Junky Cerebrum; BK: Bad Kidney"
-JC virus—progressive multifocal leukoencephalopathy (PML) in HIV.
-BK virus—transplant patients, commonly targets
kidney.
138
Smallpox
| -will vesicles be in diff stages or all in the same stage?
-all in the same stage.
139
HSV-2
| -where do they go latent?
Sacral ganglia.
140
VZV
| -will vesicles be in diff stages or all in the same stage?
Different stages.
141
Most common complication of shingles is:
post-herpetic neuralgia.
142
CMV
| -virus goes latent where?
In mononuclear cells.
| *EBV invades B cells.
143
CMV causes what type of pneumonia?
Interstitial pneumonia in almost all transplant pts from CMV.
144
CMV
| -how is it transmitted?
-Transmitted congenitally and by transfusion, sexual contact, saliva, urine, transplant.
145
HHV-6
- what disease does it cause?
- explain the disease:
- aka?
Roseola: high fevers for several days that can cause seizures, followed by a diffuse macular rash G .
- Transmitted by saliva.
- aka exanthem subitum
146
Herpes HSV-1 encephalitis
| -how to Dx?
CSF PCR for herpes encephalitis.
147
genital herpes
| -how to Dx?
- Tzanck test—a smear of an opened skin vesicle to detect multinucleated giant cells.
- Infected cells also have intranuclear Cowdry A inclusions.
148
Reoviruses
- what viruses in this family?
- whats special about reovirus genome?
- Coltivirusa—Colorado tick fever
- Rotavirus—#1 cause of fatal diarrhea in children
*dsRNA virus. segmented.
149
#1 cause of fatal diarrhea in children
Rotavirus (Reovirus).
150
Picornaviruses
- which viruses in this family?
- menmonic?
PERCH
- Poliovirus
- Echovirus—aseptic meningitis
- Rhinovirus—“common cold”
- Coxsackievirus
- HAV
151
Coxsackievirus
| -what diseases can it cause?
-aseptic meningitis; herpangina (mouth blisters, fever); hand, foot, and mouth disease; myocarditis; pericarditis.
152
Leading cause of non-bacterial gastroenteritis in USA
Calicivirus (norwalk virus) (norovirus)
153
Caliciviruses
- which virus is in this family?
- whats it cause?
- what setting do people usually get it?
- Norovirus—viral gastroenteritis
- aka norwalk virus
- cruiseships!
154
Viral Gastroenteritis on cruiseship:
Norovirus = calicivirus
| -aka norwalk virus
155
Flaviviruses
| -which viruses does this encompass?
- HCV
- Yellow fever
- Dengue
- St. Louis encephalitisa
- West Nile virusa
156
Yellow fever
| -Sxs:
-jaundice, GI hemmorhage w/black vomit.
157
- Most commonly Dx arbovirus in the US:
| - Most common arbovirus worldwide:
- West Nile virus = US
| - Dengue fever = worldwide
158
Rubella
| -which virus family?
Togavirus
159
Retroviruses
| -which viruses?
HTLV—T-cell leukemia
| HIV—AIDS
160
Coronaviruses
| -whats it cause?
Common cold & SARS.
161
Paramyxoviruses
| -which viruses?
```
PaRaMyxovirus:
Parainfluenza—croup
RSV—bronchiolitis in babies; Rx—ribavirin
Measles, Mumps
*rubella = togavirus
```
162
RSV—bronchiolitis in babies
| -Tx:
ribavirin
163
Bullet-shaped virus
rabies virus
164
Filoviruses
| -which viruses
Ebola/Marburg hemorrhagic fever
165
Ebola
| -which virus family?
Filovirus
166
Bunyaviruses
| -most notable virus in this family?
Hantavirus—hemorrhagic fever, pneumonia
167
Picornaviru
| -only non-enterovirus in this family?
rhinovirus
168
Yellow fever virus
- transmitted by what?
- which virus family?
- Sxs:
- A flavivirus (also an arbovirus) transmitted by Aedes mosquitoes.
- high fever, black vomitus, and jaundice.
169
high fever, black vomitus, and jaundice.
| -which virus?
Flavivirus => yellow fever virus.
170
Yellow fever
- Liver enzymes profile?
- what will you see histologically in liver?
- much higher AST than ALT.
- AST = 900U/l and ALT = 350U/l
- councilman bodies.
171
Acute diarrhea in the United States during winter,
especially in day-care centers, kindergartens.
-does it cause electrolyte imbalance?
Rotavirus
| -Villous destruction with atrophy leads to dec. absorption of Na+ and loss of K+.
172
Highly sensitive way to rule out asthma?
Methacholine challenge.
173
subperiosteal hematoma
| -secondary to deficiency of what?
vitamin C.
174
Friedrich ataxia
| -can lead to which heart condition?
hypertrophic cardiomyopathy.
175
Grey, subretinal membrane in old person losing vision.
- what disease?
- whats the Tx?
Age related macular degeneration.
| -anti-VEGF.
176
Inulin
- used to estimate what?
- mnemonic:
GFR
| -creatinine = inulin = GFR: CIG.
177
Spongiosis
- definition:
- seen in which diseases:
Epidermal accumulation of edematous fluid in intercellular spaces.
-seen in eczematous dermatitis: all the diseases in this umbrella term.
178
Influenza
- function of hemagglutinin:
- function of neuraminidase:
- hemagglutinin = promotes viral entry.
| - neuraminidase = promotes progeny virion release.
179
What kind of Abs and against what antigen give you immunity against influenza reinfection?
Circulating Abs against HA = immunity against
reinfection from influenza.
-IgG & IgA.
180
Antigenic shift only possible in which type of influenza?
| -why?
- Type A influenza virus.
| - bc type A can infect humans or animals.
181
Influenza pandemic caused by drift or shift?
- Shift = worse = pandemic.
| - Drift = epidemic.
182
RNA pol doesn't have which capability?
RNA polymerase does NOT have proofreading capability!
183
Anastrozole
- whats it do?
- what other drug has same mech?
- aromatase inhibitor
| - exemestane.
184
Filtration fraction: inc or dec in hypovolemia?
- inc.
| - bc RPF drops more so than GFR.
185
pertechnetate study
| -used to Dx what disease?
Finds gastric mucosa in meckels diverticulum.
186
Which 2 terminal nerves come off posterior chord?
radial & axillary n.
187
scaphoid
| -side of radius or ulna?
radius
