D&D Unit 3 Flashcards
(266 cards)
1
Q
What is the range for fitzpatrick skin types?
A
I to VI where I is super light and VI is super dark
2
Q
What are the 2 types of melanin?
A
Eumelanin - black/bron
Pheomelanin - yellow/red-brown
3
Q
What is the melanin distribution difference between light and dark skin?
A
Light - melanosomes are distributed in clusters above the nucleus
Dark - melanosomes are distributed individually throughout the cytoplasm
4
Q
Which skin cells synthesize vitamin D?
A
Keratinocytes
5
Q
Which skin cells provide immunologic protection?
A
Langerhans cells
I think they are the macrophages
6
Q
Which skin glands lubricate the skin?
A
Sebaceous
7
Q
Which skin glands create pheromones?
A
Apocrine glands
8
Q
What are the 2 layers of the dermis? What is their connective tissue like?
A
Papillary - loose connective tissue
Reticular - dense connective tissue
9
Q
What is the embryonic origin of melanocytes?
A
Neural crest
10
Q
How many keratinocytes get melanin from each melanocyte?
A
30
11
Q
How long does epidermis renewal take?
A
About 28 days
12
Q
What causes epidermolysis bullosa symplex?
A
Congenital defects in keratin filaments 5 and 14
13
Q
What are the 5 layers of the epidermis?
A
Stratum basalis Stratum spinosum Stratum granulosum Stratum lucidum Stratum corneum
14
Q
What does filagrin do?
A
Cross-links keratin tonofilaments
15
Q
What organs in the skin sense touch? Where are they located?
A
Meissner’s corpuscles
Papillary layer of the dermis
16
Q
What organs in the skin sense touch, vibration, and pressure? Where are they located?
A
Pacinian corpuscles
Reticular layer of the dermis
17
Q
Where are the blood vessels for thermoregulation located?
A
Reticular layer of the dermis
18
Q
What are the 2 types of sweat glands?
A
Apocrine - in axillary, pubic, perianal regions
Eccrine - everywhere else
19
Q
Downward projections of epidermis are called ________________ and interdigitate with the ______________ of the dermis
What are they for?
A
Epdermal rete
Dermal papillae
Increase strength of adherence and surface area between epidermis and dermis
20
Q
Which collagen is most prevalent in the adult dermis?
A
Collage I
21
Q
Which collagen is most prevalent in the fetal dermis?
A
Collagen II
22
Q
Which collagen is most prevalent in the basement membrane?
A
Collagen IV
23
Q
Which collagen attaches the epidermis and dermis?
A
Collagen VII
24
Q
What is the structure of collagen?
A
3 chains arranged in an alpha helix
Striations at 68nm intervals. These are usually Gly-Pro-Hydroxyproline
25
What is an important cofactor required for extracellular assembly of collagen fibrils?
Vitamin C (ascorbic acid)
26
How do you tell microscopically if skin is from an old person or a sun-exposed site?
Presence of solar elastosis
| They are basophilic
27
What happens to the skin in pseudoxanthoma elasticum?
Elastic fibers become enlarged, tangled, calcified
28
What 2 things is ground substance made of?
Hyaluronic acid
Dermatan sulfate
They are both glycosaminoglycans
29
What is auspitz sign?
In psoriasis, when scales are removed, pinpoint bleeding occurs
30
What causes leukocytoclastic vasculitis?
Immune complexes form and precipitate in vessel walls
- > inflammation
- > palpable purpura
31
What is itch n medical terms?
Pruritus
32
Where do nerves end in the skin:?
The dermoepidermal junction
33
What are the afferent nerves for pruritus?
Small, unmyelinated C fibers with a slow conduction rate
34
What do Pacinian corpuscles resemble?
| What do Meissner's corpuscles resemble?
Onion
| Pinecone
35
What are the 2 types of hairs?
Terminal hairs
| Vellus hairs
36
What are the 3 areas of a hair?
Infundibulum
Isthmus (from the sebaceous duct to insertion of arector pili)
Matrical area
37
What embryonic structure is the follicular unit derived from?
Primitive ectodermal germ
38
What are the lower, middle, and upper bulges of the primitive ectodermal germ for?
Lower - attachment for arrector pili
Middle - sebaceous gland
Upper - apocrine gland
39
What are the 3 growth phases hair can be in?
Anagen - growth
Telogen - resting
Catagen - transition between anagen and telogen
40
What 2 treatments are there for androgenic alopecia?
5-alpha-reductase inhibitor (blocks conversion of testosterone to 5-dihydrotestosterone
Minoxidil
41
What are the 3 parts of the eccrine gland?
Coiled secretory portion
Intradermal duct
Intraepidermal portion
From deep to surface
42
What neurotransmitter triggers sweating?
Acetylcholine
43
What part of the autonomic nervous system triggers sweating (sympathetic or parasympathetic)?
Sympathetic
44
Where are apoeccrine glands found?
Axilla
45
Albnism is due to a defect in the _________ gene in the melanin production pathway
Tyrosinase
46
Where are 3 places we get vitamin D from?
Sun exposure
Fish/figh liver oils
Egg yolks
47
What causes rickets?
Vitamin D deficiency
48
Which layer are skin stem cells located in?
Basal cell layer (stratum basalis)
49
Where in the skin are hemidesmosomes found?
They attach the basal cells to the basal lamina of the dermal-epidermal junction
50
What is bullous pemphigoid?
Autoimmune response to hemidesmosomes, causing the dermal-epidermal junction to separate -> subepidermal blisters
Antibodies to BP230 or BP180
51
What is epidermolysis bullosa?
Defect in laminin 5 -> blistering
52
What is dystrophic epidermolysis bullosa?
Defect in collagen VII -> scarring, flexion contractures
| Autosomal recessive
53
What is pemphigus vulgaris?
An acquired autoimmune disease with antibodies to desmoglein 1 and desmoglein 3
-> flaccid bulla, intraepidermal blisters
54
What is epidermolysis bullosa simplex?
Genetic defects in keratin 5 and 14
55
What is the breakdown product of filaggrin?
Natural moisturizing factor. It binds water to keep the skin moist
56
What causes icthyosis vulgaris and atopic dermatitis?
Loss-of-function filaggrin mutations -> defective skin barrier function.
There are significantly reduced levels of natural moisturizing factor, so more water loss occurs
57
What are Merkel cells for? Where are they?
They are important for neural development and tactile sensation
They are small cells associated with nerve endings in the epidermis
58
Where is stratum lucidum located? What does it do?
In thick skin
| It helps reduce friction and shear forces between the stratum corneum and stratum granulosum
59
What is are dermatologic terms for flat things (2)?
Macule - A flat area of color change 1 cm
| Patch >1 cm
60
What are dermatologic terms for elevated things (3)?
Papule - 1cm. Width > thickness
Nodule - >1 cm
Plaque >2 cm
61
What is scale?
Excess stratum corneum
Can come as flakes or plates
Color is usually white or grey
62
What is crust?
Dried blood, serum, or purulent exudate that forms on the skin surface
63
What are dermatologic terms for fluid filled things?
Vesicle- 1cm filled with blood or fluid
Bulla >1 cm
Pustule filled with pus
64
What are the 2 types of bullas?
Tense
| Flaccid
65
What are dermatologic terms for pus-filled things?
Pustile - >1 cm, circumscribed elevation
66
What defines an ulcer?
| What 3 things further classify it
A circumscribed loss of epidermis and at least upper dermis
Depth
Edge
Tissue at base
67
What is an eschar?
A scab!
| A black, adherent, thicky, dry crust
68
What is a dermatologic condition that is distributed following lymphatic vessels?
Lymphangitic
69
What is a dermatologic condition that is distributed on palms and soles?
Palmoplantar
70
What is a dermatologic condition that is distributed in regions with skin-skin contact that causes friction?
Intertriginous
71
What is a dermatologic condition that is distributed on skin overlaying muscles that flex joints?
Flexural
72
What are the collagen differences between the papillary and reticular dermis?
Papillary - thin collagen bundles
| REticular - thick collagen bundles
73
Procollagen is synthesizes within fibroblasts and extracellularly and enzymatically cleaved into ____________
Tropocollagen
74
What is Ehlers-Danlos syndrome? What are 4 symptoms?
```
A group of diseases with messed up collagen synthesis
Hyperextensible skin
Hyperextensible joints
Fragile blood vessels
Poor wound healing
```
75
What is pseudoxanthoma elasticum? What are 4 symptoms?
Mutation in MDR gene
-> calcified, brittle elastic fibers
Plucked chicken skin
Systemic hypertension
Angioid streaks in retina
Arterial rupture (particuarly in eye)
76
Are there genetic diseases of ground substance?
No
77
Does the epidermis contain vasculature?
No
78
What are the 2 types of skin vessels?
Superficial and deep plexi
79
What are the 2 main differences between type A and C nerve fibers?
A - heavily myelinated, rpid conduction
| C - unmyelinated, slow-conducting
80
What are the 4 subtypes of type A fibers?
A-alpha - proprioception and large motor units (largest)
A-beta - touch
A-gamma - spindle organs in muscle stretch receptors
A-delta - fast-localizing initial component of pain (smallest)
81
Does hair form from the outside in or inside out embryologically?
Outside in
| The mesenchyme induces the overlying neuroecoderm to bud downwards
82
What is milaria?
Prickly heat
| From blocked sweat ducts (the eccrine ones)
83
What is anhidrotic ectodermal dysplasia?
Mutant EDA gene
Abberant eccrine development
-> decreased sweating
-> poor temperature regulation
Also get other ectoderm problems like sparse hair and abnormal teeth
84
What is seborrheic dermatitis a more severe form of? What 4 things is it seen in?
Dandruff that can affect scalp, face, upper torso
Parkinson's
Head trauma
HIV
Chronic neurologic conditions like cerebral palsy
85
What 4 skin problems are found in diabetes?
Acanthosis nigricans
Yellow skin
Brown patches on lower legs
Foot ulcers
86
What is the skin like in hyperthyroidism? (2)
Smooth, warm, moist
| Pretibial myxedema
87
What is the skin like in hypothyroidism? (5)
```
Dry skin
Brittle nails
Sparse hair
Delayed wound healing
Puffy madarosis (loss of lateral third of eyebrow)
```
88
What is stasis dermatitis?
Chronic venous insufficiency of lower extremities with lower extremity edema
Often seen with other things due to venous insufficiency down there
89
What are the differences in morphology and location of inflammation between dermatitis and cellulitis?
Dermatitis has erythematous papules and thin plaques with scale
Cellulitis is warm, tender erythematous patches or plaques
Dermatitis is in the epidermis/dermis.
Cellulitis is in the dermis and subcutaneous tissues
90
How do you diagnose allergic contact dermatitis?
Patch testing
91
What is the most frequent dermatologic allergen?
Nickel sulfate
92
What is dermatitis also called?
Eczema
93
Where are venous stasis ulcers usually? What do they look like?
On medial lower leg just above ankle.
Red with yellow fibrinous base
Borders irregularly shaped
Can be purulent f infected
94
What is infantile atopic dermatitis?
Dry, red, scaly areas on the cheeks that become flushed w/ cold exposure
Usually under 5 years of age
95
What is the most common type of contact dermatitis?
Irritant contact dermatitis
96
What 3 things does allergic contact dermatitis require?
Exposure of an allergen
Immune response
Development of memory T cells
97
3 risk factors for nckel sensitivity
Female
Young
Exposure
98
What 2 ointments often have sensitivity reactions?
Neomycin
| Bacitracin
99
What is the usual time course for drug eruptions?
1-2 weeks after starting a new medication
| Starts sooner if given a medication previously reacted to before
100
What type of immune hypersensitivity is urticaria?
Type I - mediated by IgE
101
What is nummular dermatitis caused by?
Excess use of soap and dry skin
102
What causes seborrheic dermatitis? (2)
A combination of overproduction of skin oil and irritation from yeast )malassezia furfur)
103
4 subtypes of psoriasis
Chronic plaque disease
Guttate
Erythroderma
Pustular psoriasis
104
2 comorbidities for psoriasis
Metabolic syndrome
| Cardiovascular disease
105
How long does it take for a fingernail to grow out?
6 months
106
What is the diabetic rash on the shin?
Necrobiosis lipoidica
107
What are Janeway lesions?
Septic microemboli that cause bruises
108
What are osler nodes?
Raised, red legions on hands and feet
Erythematous, painful vasculitis
Found in endocarditis
109
What are Roth spots?
Retinal hemorrhages
110
How do you get strep viridans in the blood?
Teeth - usually dental cleaning
111
What happens in systemic scleroderma? (3)
Thickened skin (hands, mouth, esophagus, GI)
Raynaud's
Pulmonary hypertension
112
What happens in lichen planus? (4)
Purple, polygonal, pruritic papules
Lace-like white lines
Mucosal lesions
Nail involvement (like white lines there)
113
What 3 things differentiate an expanding ulcer from a regular ulcer? How do you treat them?
Has a sharp drop-off edge
Not usually in places with bad circulation
More common in inflammatory disease
Treat with steroids, NOT antibiotics
114
What are 2 nail discoloration findings where the tips turn red?
over half red - renal problems
| less than half - cirrhosis, congestive heart failure
115
What should are 6 dermatologic clues someone has cancer?
Erythema gyratum repens (whorly red marks)
Hypertrichosis languinosa acquisita (extra languo)
Tripe palms
Lesser trellat sign (explosive onset of multiple seborrheic keratoses)
Dermatomyositis
Sister Mary Joseph Node
116
Where on the body are drug rashes?
Trunk, not extremities
117
What are the pH differences between normal and pathogenic skin bacteria's preferred environments.
Normal - acidic
| Bad - neutral
118
What are the 2 bacteria that cause impetigo?
Beta-hemolytic streptococci -> non-bullous impetigo
| Staphylococcus aureus -> both non-bullous and bullous impetigo
119
What is the food source for candida (2)?
Glucose
| Serum
120
What is the fancy-ass dermatologic term for skin tag?
Acrochordon
121
What is a junctional nevi?
Nevus cells are at the dermal-epidermal junction just above the basement membrane zone of the epidermis
Not super elevated nevus
122
Are fried-egg nevi malignant?
No but they are in people with increased risk of melanoma development
123
What condition is basophilia seen in?
CML - chronic myeloid leukemia
124
What is the definition of acute leukemia?
Neoplastic proliferation of blasts
| They are >20% of the bone marrow
125
What is a good way to test for ALL (acute lymphoblastic leukemia)
AML (acute myeloblastic leukemia) (2)
tdt positivity in nucleus
Myeloperoxidase and auer rod
126
What are the 2 subtypes of ALL? Which is most common?
B-ALL (most common)
| T-ALL
127
What CDs are important in B-ALL?
CD10, CD19, CD20
128
What are the 2 translocations commonly seen in B-ALLL?
Prognosis?
Patient population?
t(12;21) Good prognosis. Children
t(9;22) Poor prognosis. Adults. This is the Philadelphia chromosome
129
What CDs are important in T-ALL?
2-8
| No 10
130
Which hematologic malignancy has increased risk for DIC?
acute promyelocytic leukemia
131
What is a good way to test for acut emonocytic leukemia?
They don't have myeloperoxidase
132
How id impetigo most commonly acquired?
Person-to-person contact
133
What is a rash on the cheeks with an indurated sharp border?
Erysipelas
134
What fungus causes jock itch and athlete's foot?
Epidermophyton
135
What are the 3 common dermatophyte fungi? What do they eat?
Epidermophyton
Microsporum
Trichophyton
They eat keratin
136
What is the most common dermatophyte?
Trichophyton
137
What is a tinea infection that forms a plaque?
Kerion
138
What happens if you treat a fungal skin infection with topical steroids?
It goes into the hair follicles, because steroids reduce immune response
Inflammed follicles - Majocchi's granuloma
Must treat with systemic steroids now
139
What does tinea look like with KOH?
Long, branching, septate hyphae
140
What is candidiasis on the corners of the mouth?
Perleche
141
What is candidiasis between the fingers?
Erosio interdigitalis blastomycetica chronica
142
What does tinea versicolor eat?
Follicular lipids (which is why its patient population is post-pubertal)
143
What fungal infection looks like spaghetti and meatballs with KOH?
Tinea versicolor
144
What is Klippel-Trenaunay syndrome?
Overgrowth of an extremity covered by a large port wine stain
Becasue of vascular abnormalities
145
What is the dermatologic dimple sign?
When you push in the sides, it indents
146
What is seborrheic keratosis?
A benign tumor of the hair follicle
147
Basal cell carcinomas arise from pluripotent cells due to mutations in the ___________ pathway
The most common mutant gene in this pathway is __________
Hedgehog
Patched 1
148
What is the most common pre-malignant skin lesion?
Actinic keratoses
149
The most important indicator of progress in melanoma is ________
Breslow depth
| This is the maximal thickness of tumor invasion (mm)
150
What is the Clarck level?
It describes how what layer of the skin a melanoma has penetrated
I (epidermis) to V (subcutis)
151
Kaposi sarcoma is a cancer of _______
Endothelial cells
152
How do the wavelengths of UVA and UVB compare?
UVA is longer wavelength
153
3 types of DNA damage from UV radiation
Thymiine dimer
Pyrimidine-6-4 pyrimodone
Hydroxyguanosine
154
What 3 ways things can move into the skin?
Passive diffusion
Active transport
Transport via appendageal structures like sweat glands and hair follicles
155
What is the difference between and ointment and a cream?
Ointments are water in an oil emulsion
| Creams are oil in a water emulsion
156
How do glucocorticosteroids affect the NF-KB pathway?
They inhibit it, leading to reduction in transcription of cytokines, adhesion mlcs, inflammatory enzymes, and growth factors
157
What 3 glucocorticosteroids do we care most about in derm?
In order of potency:
Hydrocortisone
Triamcinolone Acetonide
Clobetasol Propionate
158
What is a disadvantage to an ointment?
Patients may dislike greasiness
| May stain clothing
159
What is a disadvantage to a cream?
Significant sensitization risk
160
What is a disadvantage to a gel?
Significant sentitizaiton risk
| Relatively high irritaion risk
161
How many grams is a fingertip unit?
0.5
162
How is potency of topical steroids evaluated?
Vasoconstrictor assays
163
What are the 2 primary proinflammatory cytokines?
IL-1
| IFN-Y
164
What enzyme excises mutated DNA strands?
UVR ABC nuclease
165
5 enzyme defenses against ROS in the epidermis
```
Peroxidase
Catalase
Superoxide dismutase
Glutathione reductase
Thioredoxin reductase
```
166
The rate limiting enzyme in the melanin production pathway is ___________________
Tyrosinase
167
What are 5 things UV light helps?
```
Psoriasis
Atopic dermatitis
Cutaneous T cell lymphoma
Mastocytosis
Vitiligo
```
168
What is the most common malignancy in teh US?
Basal cell carcinoma
169
What drug is used for basal cell carcinoma?
Vismodegib
170
What skin condition often becomes skin cancer?
```
Actinic keratosis
(intraepidermal neoplasia)
```
171
What is Bowen's disease?
Squamous cell carcinoma in situ
172
What is the gene most frequetly mutated in maloma?
BRAF
173
Which layer are epidermal stem cells in?
Stratum basalis
174
Where in the skin are desmosomes and hemidesmosomes?
Desmosomes connect epidermal cells
Hemidesmosomes connect the dermis and epidermis
175
What is the differentce between atopic dermatitis and contact dermatitis?
What is their clinical presentation (5)
They are both pruritic, erythematous, oozing rashes with vesicles and edema
Atopic dermatitis is a type 1 hypersensitivity where the irritant is not known. The irritant is known in contact dermatitis
176
What are 3 therapies for psoriasis?
Corticosteroids (topical)
UVA light - stops abnormal keratinocyte proliferation
Immune-modulating therapy
177
What are the 5 P's of the lichen planus signs?
Prutitic, planar, polygonal, purple papules
178
What is the difference between pemphigus and pemphigoid?
Pemphigus - separation is in epidermis
| Pemphigoid - separation of dermis and epidermis at the basement membrane
179
What are 2 worse forms of erythema multiforme?
What is the main difference, besides being worse?
Steven Johnson
TEN (toxic epidermal necrolysis)
They have oral mucosa involvement
180
What is the cause of erythema multiforme? What about Steven Johnson/TEN?
EM - herpes reaction most commonly but can also be autoimmune, drugs, or other pathogen
SJS is usually an adverse drug reaction
181
Leser-Trelat sign is a sudden onset of multiple _______
Seborrheic keratosis
182
What is the main genetic mutation (like on the molecular level) in basal cell carcinoma? What causes it?
Pyrimidine dimers
| UVB
183
What skin condition is the precursors to squamous cell carcinoma?
Actinic keratosis
184
What are the 3 steps of mole growth?
Grow along the dermal-epidermal junction - junctional nevus
Extend down into nevus - compound nevus
Junctional component then disappears - intradermal nevus
185
What is the most common complication of polycythemia vera?
Acute clotting event
186
BCR-ABL always in ____________ and adult ____________ sometimes
CML
| AML
187
Which cytokine (?) suppresses immune responses and is released by Tregs?
TGF-B
188
What cytokine is most responsible for the inflammatory reactions in the gut?
IL-6
189
What 3 grains is gluten in?
Wheat
Rye
Barley
190
What are Koch's postulates showing that microbes cause specific diseases (4)
1. Specific microbes are present regularly in characteristic lesions of the disease
2. The specific microbes can be isolated and grown in vitro
3. Injection of the cultured microbes into animals reproduces the disease seen in humans
4. The specific microbes can be re-isolated from lesions of the disease in animals
191
In a virus, what is the RNA strand that contains the translatable open reading frame that is 'ribosome-ready'?
+ strand
192
what is the eclipse period in viral infection?
Occurs after virus adsorption
When no infectious virus is detectable inside or outside the cell
This is because they have released their genomes into the cell
193
What is the latent period in viral infection?
The period between initiation of infection to the release of new viruses from the cell
194
What is the unique viral enzyme used to produce mRNA and replicate RNA?
RNA-dependent RNA polymerase
195
What are the 2 ways packaging of the genome into the capsid occurs in icosahedral capsids? What about helical nucleocapsids?
The capsid assembles around the virus genome
The genome is fed into preformed capsids
The viral genome is coated with nucleocapsid protein during its synthesis
196
What is viral tropism?
The fact that viruses infect some tissues and not others
Determined by access to tissue
Receptors
Expression of host genes required for virus infection and production of new progeny virus
Failure of host defences
197
Are enveloped or non-enveloped viruses hardier?
Non-enveloped ones
198
What is the difference between type I and II interferones?
Type I are made by infected cells
| Type II are made by T and NK cells
199
What are the 4 things used to classify viruses
Genetic material: DNA/RNA
Capsid: helical/icosahedral
Naked/enveloped
Size
200
What is a spike in terms of viruses?
Virus-derived membrane-bound blycoproteins
201
What is the difference between a virus-susceptible and permissive cell?
Susceptible has a functional receptor for the virus
| Permissive has capacity to replicate the virus
202
What is viremia?
The presence of viruses in the blood
203
What is APOBEC3G?
A human protein that interferes with the replication of HIV by incorporating itself into virus particles and damaging the genetic material of the virus
204
What is Vif?
An HIV protein that blocks APOBEC3G by
1. binding to APOBEC3G
2. Targeting APOBEC3G for destrution/elimination
205
What Type I IFNs (2) do we care about? What Type II IFN (1)
IFN-A, IFN-B
IFN-Y
206
What cells produce type II interferons?
T and NK cells
207
Type I interferons regulate control genes through ______________
Type I interferons do this through __________
ISREs (interferon-stimulated response elements)
| GAS (gamma activated site elements)
208
Cells respond to interferons through receptor activation of _________ signalling
Jak/Stat
209
What are 2 mediators of hte IFN-induced anti-viral state we care about? They reduce protein production ultimately.
What are they activated by?
PKR - a protein kinases that decreases protein synthesis by inactivating some translation initiation factors
OAS - activates a cellular ribonuclease that degrades mRNA
Both are activated by dsRNA
210
How do drugs inhibit viral uncoating?
They block the virally-encoded H+ ion channel so that the pH change necessary for uncoating can't occur
211
What is the nucleic acid of choice for herpes?
What is their capsid-shape?
Are they envoloped?
dsDNA (linear)
Icosahedral capsid
Envelope
212
What are the latentcy sites of the 3 herpes subfamilies?
Alpha - sensory ganglia
Beta - monocytes, lymphocytes
Gamma - B cells
213
How is herpes assembled? How does it leave the nucleus.
Assembly occurs in the nucleus and capsids self-assemble
Then the virus gets its envelope from the Golgi
Then it leaves through exocytosis or lysis
214
Which herpes is oral and which is genital?
HSV-1 -> orofacial/ocular lesions
HSV-2 -> genitals
Most commonly! Can actually be anywhere
215
Are most primary HSV infections symptomatic?
No
216
Where do latent HSV1 and HSV2 hang out?
1 - trigemnal ganglion
| 2 - sacral ganglion
217
Where is herpetic whitlow? Where does it come from?
Fingers
| Oral secretions
218
Where is herpes keratitis?
Cornea
219
At what point is chicken pox no longer infected?
When all the lesions are scabbed (about 7 days)
220
Where does latent varicella zoster virus hang out?
Nerve ganglia associated with areas in which the virus was present in the skin
221
Does varicella zoster exhibit asymptomatic viral shedding in normal hosts that experience reactivation?
No! It is the only herpesvirus that does not.
222
What is the nucleic acid for influenza?
RNA
223
What are the 2 types of drugs we use to treat influenza?
Matrix protein inhibitors - only for subtype A
| Neuraminidase inhibitors - for both subtypes A and B
224
What virus is the most common cause of bronchiolitis?
Respiratory syncytial virus
225
What is the nucleic acid for RSV?
ssRNA
226
What are F and G proteins for RSV?
F - fusion of viral envelope t host cell and membranes of infected cells (syncytia)
G - initial binding of virus to host cell
227
What is the difference between pemphigus and pemphigoid?
Pemphigus - epidermal separation
| Pempigoid - dermal-epidermal separation
228
Proximal subungal white onchomycosis is associated with what other disease?
HIV
229
Proximal subungal white onchomycosis is due to ________
Trichophyton infection
230
Which dermatologic condition is on flexor surfaces? Which is on extensor surfaces?
Atopic dermatitis
| Psoriasis
231
In chicken pox, do lesions present at the same stage?
no
| Lesions are in multiple stages in the same body regions
232
Do shingles lesions cross the midline?
No
233
Where does CMV establish latency?
Monocytes and lymphocytes
234
Where does reactivated CMV shed?
Urine and saliva
235
How does acyclovir help reduce influenza infection?
Blocks nucleic acid synthesis
| Terminates DNA chains (may only be in herpes)
236
Which drug blocks influenza nucleic acid synthesis?
Acyclovir
237
What do amantadine and rimantadine do in influenza infections?
Prevent viral uncoating by blocking H+ channel formation, thus preventing pH change necessary for uncoating
238
Which drugs (2) block influenza uncoating
Amantadine
| Rimantidine
239
What do zanamivir and oseltamivir do in influenza infections?
Prevent viral release from cells
240
Which drugs (2) block influenza release from cells?
Zanamivir
| Oseltamivir
241
Neuraminidase inhibitors are most effective when started within _______ hours after symptom onset
48
242
How is zanamivir administered?
Inhalation
243
Which drug prevents the herpes virus family from attaching to cells?
Docosanol
244
What does docosanol do?
Prevents herpes viral attachment to cells
245
What 3 drugs inhibit herpes family viral DNA polymerase?
Acyclovir
Roscarnet
Ganciclovir
246
What do acyclovir, roscarnet, and gancyclovi do?
Inhibit herpes viral DNA polymerase
247
What is resistance to acyclovir usually from?
Reduction or loss of expression of viral tyrosine kinase
248
What is the active form of vitamin D? What organ synthesizes it?
Calcitriol
| Kidneys
249
Which UVR converts 7-dehydrocholesterol to vitamin D3?
UVB
250
What does the liver convert D2 and D3 to?
Calcidiol
251
What is the difference between eclipse and latent phases of viral infection?
Eclipse - no viruses detectable becaseu they are being replicated
Latent - period from infection until viruses are detectable outside cells
252
Cholera is _______ mediated
Pneumonia is _______cellular bacteria
TB is _____cellular bacteria
Toxin
Extra
Intra
253
What are viral spikes?
Virally-encoded glycoproteins
254
What is the nucleic acid for the herpes family?
dsDNA
255
What is a holocrine gland? Which one is on the skin?
A holocrine gland excretes whole cells
| Sebaceous gland
256
What can you treat infantile hemangiomas with?
Beta blockers
257
Kaposi's sarcoma is a malignancy of _______
Melanocytes
258
Malassazea furfur causes which 2 skin diseases?
Tinea versicolor
| Seborrheic dermatitis
259
What are the 2 types of empetigo and which bacteria causes each?
Bullous - staph
| Nonbullous - strep
260
What color is eumelanin?
Red/brown
261
What is the nucleic acid for RSV and influenza?
ssRNA
262
What is valacyclovir?
A prodrug of acyclovir that has better bioavailability
263
How does acyclovir dose compare between VZV and HSV?
VZV is less sensitive and requires higher dose
264
Within what time frame do you begin acyclovir treatment for stuff like shingles?
265
What is a cell resistant to viral infection?
It does not have receptors to allow the virus entry
266
What is FAMMM?
Familial atypical multiple mole melanoma
