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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
cocobacilli
``` ELLA brucella pastruella francisella bordatella hemopHILLA (hemophilus) ```
26
curved rods
all are OXIDASE +ve grows in alkaline media ---- V.cholera urease +ve -------- h.pylori grows in 42degrees -------- c. jejuni
27
Bacilli classification in order
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
28
lactose fermentors slow vs fast
Fast ---- E coli , klebsiella, Enterobacter | Slow ---- serratia, Citrobacter
29
non fermentors OXIDASE +ve -ve
oxidase +ve -------- PSEUDOmonas oxidase -ve non motile non H2S ---- shigella yersinia oxidase -ve motile H2S -------- salmonella, proteus
30
exotoxin vs endotoxin | high dosage required for infection
Exo needs high | Endo low
31
secreted exo vs endo
exo is secreted
32
LPS exo vs endo
endo has LPS lipid A | exo has polypeptide
33
phage/ plasmid endovs exo
exo ---- remember plasmid is Extra chromosomal genetic material so it is used to make EXOtoxin chormosome for endo
34
destroyed at 60 degreeess
exo
35
which bacteria produce IgA protease and what is the function of this
``` igA protease enables these bacteria to adhere and colonize SHIN Strept pneumo Hemophilus Influenza Nisseria ``` Transformation IgA protease Encapsulated
36
Small Count Enough for Gastroenteritis
Shigella Camphylobacter jejuni Entameba Giardia
37
LPS vs LOS
LPS in all G negative bateria | LOS in N. meningitidis
38
Porins mode of resistance
Pseudomonas | throw out antibiotic
39
cell wall protects againts
osmotic damage
40
where are penicillin binding protein found
in the cytoplasmic membrane | mode of resistance acquired by changing the PBP ----- MRSA
41
gram positive lipoteichoic acid induces whch cytokines
TNF alpha | IL 1
42
Disseminated TB
``` TB meningitis primary adrenal insufficiency pott spine --------- bambooo pericarditis/pleuritis PSOAS abcess ```
43
poly D glutamate capsule
B anthrax | prevents againts phagocytosis
44
which antibiotics target cell wall
penicillins cephalosporins carbapenems monobactams fosfomycin --- not systemic bacitracin
45
slime layer (polysaccharide) found in
foreign surface indwelling catheter / peritoneal dialysis/ prosthetic valve in heart coagulase - staph epidermis
46
E coli virulence factors
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
e coli neonatal meningitis specific type of virulence factor
K 1 capsule
48
spores --- characteristics
dipicolinic acid / keratin coat/ DNA / peptidoglycan dehydration resistant /temp/ chemicals
49
which bacteria make spores and how to get rid of spoes
``` bacillus anthrax/ cereus (cereulide) reheated rice clostridium tetani botulinum perfringens difficile ``` autoclave 15 mins 121 degreees
50
what is the change in prions
alpha helix to beta | prpc to prpsc
51
bacillus cereus infection timeline
1-5 hrs ------- nausea vomit | 5-18 hrs ------- GI upset diarrhea
52
unhygenic clamping of umbilical cord can cause
tetanus | spasms diff feeding trismus
53
tetanus vaccine given at ?
2 months | if endemic then ------- 4-6 weeeks
54
what type of vaccination is given to pregnanct women to avoid tetanus
toxoid | igG crosses placenta and reduces incidence
55
treatment of tetanus in adults
boooster Ab DIAZEPAM ---- treat spasticity debridment
56
c. tetani exotoxin
SNARE renshaw cells inhibit release of GABA/glycin
57
c, botulinum
inhibit relase of Ach canned foods diplopia, dysphagia, dyspnea, dysarthria honey (spores) baby presents with lethargy/ poor feedingf
58
c. perfingens exotoxin
alpha toxin lecithinase/phospholipase myonecrosis /CREPITUS/ gas gangrene heat labile spores generate
59
how long does food posning last in c. perfingen infection
<12 hours | subsides within 24 hrs
60
c. difficile
toxin A ----- binds to brush border | toxin B ---- cytotoxin --- actin DE polymerization
61
which drugs can lead to increase risk of pseudomembranocolitis
clindamycin quinolones ppi ampicillin
62
how to prevent spread of c. difficile
hand washing alcohol sanitizing non sterile gloves
63
what could be a complication of patchy pseudomembranocolitis
neutrophils inflammaton ----- necrotic epithelium ----- dialation of colon ----- TOXIC MEGACOLON without any obstruction R/O ----- perforation and peritonitis
64
diagnosis of c diff
PCR | toxin assay
65
treatment for c diff
1- ORAL VANCO 2- metronidazole (nitrogen free radicles) fidaxomycin (- RNA polymerase) FMT
66
virulence factors | IgA protease
``` SHIN strept pneumo Hem inf Inflenza Nissera ``` Transformation I gA protease Encapsulated
67
Protein A
staph aureus | prevents activation of the classical pathway
68
M protein
stept pyogene GABS prevents phagocytosis molecular mimicry ---- shares common epitope and leads to rheumatic fever
69
what other condition involved molecular mimicry
guillain Barre syndrom
70
IL 1 IL 6 cause
fever
71
TNF alpha
fever and HYPOTENSION
72
nitric oxide
HYPOTENSION
73
septic shock BP afterload CO and MVO2
bp dec afterload dec CO inc MVO2 inc
74
what activates coagulation cascade
TISSUE FACTOR
75
Disseminated Intravascular Coagulopathy seen in
Delivery --- abruptio placenta/ amniotic fluid Infection ----- ecoli/nisseria meningtidis (acute adrenal insuff) waterhouse freidrichsen syndrome Cancer ------ adenocarcinoma
76
what activates the extrinsic pathway
mucin

dr taher classes HK (24 decks)

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