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dr taher classes HK > CVS 6 > Flashcards

CVS 6 Flashcards

1
Q

tertiary syphilis findings

A 
3- 15 years
neurosyphilis --- tabes dorsalis
aortitis ---- destruction of vasa vorum
gumas ---- chronic granulomas
argyl roberston pupil
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2
Q

which conditions can involve the dorsal column

A 
T dorsalis (teritary syphilis)
Vit b12/ vit E deficiency ----- SACD
brown sequard syndrome
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3
Q

b12 def can be caused by

A

pernicious anemia
vegan diet
D. LATUM

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4
Q

b12 def leads to what type of demyelinating conditions

A

subacute combined degeneration
involves dorsal column ( fine touch vibration and proprioception)
lateral corticospinal tract ( skilled movement) UMN lesion

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5
Q

what are charcot joints

and what is the most common cause of these joints?

A

painless paralyzed joints

mcc diabetes

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6
Q

describe diebetic neuropathy

A

mono neuritis multiplex

  1. claw hand ( ulnar nerve) C8-T1
  2. wrist drop (radial nerve) C5-T1
  3. foot drop ( peroneal nerve) L4-S2
  4. carpal tunnel (median nerve) C5- T1
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7
Q

argyl robertson pupil

A

does NOT react
but accomodates

pupillary reaction absent — no constriction on shining light

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8
Q

Marcus gunn pupil seen in

A

MS

HLA DR2

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9
Q

afferent vs efferent in pupillary reaction

A

a- CN II optic nerve
e- CN III occulomotor nerve
nucleus — edinger westpal (midbrain)

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10
Q

swinging flash light

A
  1. shine light in defective eye — vague constriction
  2. swing to nromal eye —- both eyes contrict
  3. back to defective eye —- both DIALATE
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11
Q

different causes of dementia

A 
mcc of dementia --- alzheimers senile >60 years
vascular dementia --- stepwise decline
frontotemporal dementia 
lewybody dementia (hallucinations)
prion disease
normal pressure hydrocephalus
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12
Q

what are the reversible causes of dementia

A

B12 def
hypothyroidism depression
delirium

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13
Q

personality changes are seen in

A

disinhibition syndrom — frontal lobe

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14
Q

Dementia is seen when which part of the brain is affected

A

temporal lobe ( hippocampus)

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15
Q

false Positive VDRL

A 
P VDRL 
Pregnancy
Viral infection
Drugs (shippe)
Rheumatic fever
Lupus/Leprosy
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16
Q

shippe drugs

A 
drug induced lupus 
Sulfonamides
Hydralazine
Isoniazid
Procainamide (IA)
Phenytoin
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17
Q

treatment for syphilis

A

IM penicillin G

neurosyphilis ( benzathine penicillin)

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18
Q

orla penicillin examples

A 
VODKA
V penV
Oxacillin
Dicloxacillin
Kloxacillin
Ampicillin/amoxicillin
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19
Q

congenital syphilis characteristics

A 
saber shins 
hunchington teeth
saddle nose
snuffles nasal discharge
mulberry molars
8th CN deafness
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20
Q

mulberry inclusions are seen in?

A

EHRLICHIA
tick vector — in minutes
with morulae —- mulberry inclusion

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21
Q

where are blueberry muffin lesions seen

A

Rubella (togavirus)

extramedullary hematopoesis

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22
Q

pt with syphilis txt presents with fever chills joint pain myalgia

A

penicillin is working —- outer cell membrane endotoxin

jarisch herxheimer reaction

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23
Q

what is the initial classification of gram negative bacteria

A

diplococci
cocobacilli
bacilli
curved rods

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24
Q

diplococci G-

A

matlose + ——– n.meningitidis

maltose -ve —- n.gonorrhea, moraxella

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25
Q

cocobacilli

A 
ELLA
brucella
pastruella
francisella
bordatella
hemopHILLA (hemophilus)
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26
Q

curved rods

A

all are OXIDASE +ve
grows in alkaline media —- V.cholera
urease +ve ——– h.pylori
grows in 42degrees ——– c. jejuni

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27
Q

Bacilli classification in order

A
  1. lactose fermentors
  2. +ve Lactose fermentors —– FAST vs SLOW
  3. non fermentors further classified by Oxidase + -
  4. Oxidase -ve —- motile H2S vs non motile nonH2S
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28
Q

lactose fermentors slow vs fast

A

Fast —- E coli , klebsiella, Enterobacter

Slow —- serratia, Citrobacter

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29
Q

non fermentors OXIDASE +ve -ve

A

oxidase +ve ——– PSEUDOmonas
oxidase -ve non motile non H2S —- shigella yersinia
oxidase -ve motile H2S ——– salmonella, proteus

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30
Q

exotoxin vs endotoxin

high dosage required for infection

A

Exo needs high

Endo low

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31
Q

secreted exo vs endo

A

exo is secreted

32
Q

LPS exo vs endo

A

endo has LPS lipid A

exo has polypeptide

33
Q

phage/ plasmid endovs exo

A

exo —- remember plasmid is Extra chromosomal genetic material so it is used to make EXOtoxin

chormosome for endo

34
Q

destroyed at 60 degreeess

A

exo

35
Q

which bacteria produce IgA protease and what is the function of this

A 
igA protease enables these bacteria to adhere and colonize 
SHIN                               
Strept pneumo
Hemophilus
Influenza
Nisseria

Transformation
IgA protease
Encapsulated

36
Q

Small Count Enough for Gastroenteritis

A

Shigella
Camphylobacter jejuni
Entameba
Giardia

37
Q

LPS vs LOS

A

LPS in all G negative bateria

LOS in N. meningitidis

38
Q

Porins mode of resistance

A

Pseudomonas

throw out antibiotic

39
Q

cell wall protects againts

A

osmotic damage

40
Q

where are penicillin binding protein found

A

in the cytoplasmic membrane

mode of resistance acquired by changing the PBP —– MRSA

41
Q

gram positive lipoteichoic acid induces whch cytokines

A

TNF alpha

IL 1

42
Q

Disseminated TB

A 
TB meningitis 
primary adrenal insufficiency
pott spine --------- bambooo
pericarditis/pleuritis
PSOAS abcess
43
Q

poly D glutamate capsule

A

B anthrax

prevents againts phagocytosis

44
Q

which antibiotics target cell wall

A

penicillins
cephalosporins
carbapenems
monobactams

fosfomycin — not systemic
bacitracin

45
Q

slime layer (polysaccharide) found in

A

foreign surface indwelling catheter / peritoneal dialysis/ prosthetic valve in heart
coagulase - staph epidermis

46
Q

E coli virulence factors

A
  1. fimbrae — urothelial adherence—- UTI
  2. K1 capsular polysaccharide —– prevents against phagocytosis
  3. LPS —- bacteremia and septic shock
  4. vero toxin shiga like toxin —- bloody gastroent
  5. heat stable /heat lablie—– watery GE
    lAbile —- in air — cAMP
    stable on ground —– cGMP
47
Q

e coli neonatal meningitis specific type of virulence factor

A

K 1 capsule

48
Q

spores — characteristics

A

dipicolinic acid / keratin coat/ DNA / peptidoglycan

dehydration resistant /temp/ chemicals

49
Q

which bacteria make spores

and how to get rid of spoes

A 
bacillus anthrax/ cereus (cereulide) reheated rice
clostridium tetani
botulinum
perfringens
difficile

autoclave 15 mins 121 degreees

50
Q

what is the change in prions

A

alpha helix to beta

prpc to prpsc

51
Q

bacillus cereus infection timeline

A

1-5 hrs ——- nausea vomit

5-18 hrs ——- GI upset diarrhea

52
Q

unhygenic clamping of umbilical cord can cause

A

tetanus

spasms diff feeding trismus

53
Q

tetanus vaccine given at ?

A

2 months

if endemic then ——- 4-6 weeeks

54
Q

what type of vaccination is given to pregnanct women to avoid tetanus

A

toxoid

igG crosses placenta and reduces incidence

55
Q

treatment of tetanus in adults

A

boooster Ab
DIAZEPAM —- treat spasticity
debridment

56
Q

c. tetani exotoxin

A

SNARE
renshaw cells
inhibit release of GABA/glycin

57
Q

c, botulinum

A

inhibit relase of Ach
canned foods
diplopia, dysphagia, dyspnea, dysarthria

honey (spores)
baby presents with lethargy/ poor feedingf

58
Q

c. perfingens exotoxin

A

alpha toxin
lecithinase/phospholipase

myonecrosis /CREPITUS/ gas gangrene

heat labile spores generate

59
Q

how long does food posning last in c. perfingen infection

A

<12 hours

subsides within 24 hrs

60
Q

c. difficile

A

toxin A —– binds to brush border

toxin B —- cytotoxin — actin DE polymerization

61
Q

which drugs can lead to increase risk of pseudomembranocolitis

A

clindamycin
quinolones
ppi
ampicillin

62
Q

how to prevent spread of c. difficile

A

hand washing
alcohol sanitizing
non sterile gloves

63
Q

what could be a complication of patchy pseudomembranocolitis

A

neutrophils inflammaton —– necrotic epithelium —– dialation of colon —– TOXIC MEGACOLON without any obstruction
R/O —– perforation and peritonitis

64
Q

diagnosis of c diff

A

PCR

toxin assay

65
Q

treatment for c diff

A

1- ORAL VANCO
2- metronidazole (nitrogen free radicles)
fidaxomycin (- RNA polymerase)
FMT

66
Q

virulence factors

IgA protease

A 
SHIN 
strept pneumo
Hem inf
Inflenza
Nissera

Transformation
I gA protease
Encapsulated

67
Q

Protein A

A

staph aureus

prevents activation of the classical pathway

68
Q

M protein

A

stept pyogene GABS
prevents phagocytosis

molecular mimicry —- shares common epitope and leads to rheumatic fever

69
Q

what other condition involved molecular mimicry

A

guillain Barre syndrom

70
Q

IL 1 IL 6 cause

A

fever

71
Q

TNF alpha

A

fever and HYPOTENSION

72
Q

nitric oxide

A

HYPOTENSION

73
Q

septic shock BP afterload CO and MVO2

A

bp dec
afterload dec
CO inc
MVO2 inc

74
Q

what activates coagulation cascade

A

TISSUE FACTOR

75
Q

Disseminated Intravascular Coagulopathy seen in

A

Delivery — abruptio placenta/ amniotic fluid
Infection —– ecoli/nisseria meningtidis (acute adrenal insuff) waterhouse freidrichsen syndrome
Cancer —— adenocarcinoma

76
Q

what activates the extrinsic pathway

A

mucin

dr taher classes HK (24 decks)

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