First Aid 101-124

Question 1

Fruity odor in ketoacidosis is caused by

Answer 1

acetoacetate in blood –> acetone –> breathed out

Question 2

What enzyme matures nascent HDL to mature HDL?

Answer 2

LCAT - lethicin-cholesterol acetyltransferase

CETP - cholesterol ester transfer protein then transfers cholesterol esters to VLDL, IDL, LDL

Question 3

Function of apolipoprotein E

Answer 3

Mediates remnant uptake

in everything but LDL

Question 4

Function of apolipoprotein A1

Answer 4

Activates LCAT

only in chylomicrons and HDL

Question 5

Function of apolipoprotein C-II

Answer 5

Lipoprotein lipase cofactor
In VLDL (to make IDL), chylomicrons, HDL

Question 6

Function of apolipoprotein B-48

Answer 6

Mediates chylomicron secretion

In chylomicrons and chylomicron remnants

Question 7

Function of apolipoprotein B-100

Answer 7

Binds LDL receptor

In VLDL, IDL, LDL

Question 8

In general, all lipases degrade

Answer 8

triglycerides

Question 9

LDL transports cholesterol from

Answer 9

liver to tissue

Question 10

HDL transports cholesterol from

Answer 10

periphery to liver;
acts as repository for apolipoproteins C and E
alcohol increases HDL synthesis;
secreted from both liver and intestine

Question 11

AR
pancreatitis
hepatosplenomegaly,
no increased risk of atherosclerosis
eruptive/pruritic xanthomas

Answer 11

Type I familial dyslipidemia - hyperchylomicronemia
deficiency in either LPL (VLDL –> IDL and chylomicrons –> chylomicron remnants) or C-II (LPL cofactor)

increased cholesterol, TG, chylomicrons in blood

Question 12

AD
corneal arcus
can have MI before age 20

Answer 12

familial hypercholesterolemia (type II familial dyslipidemia);
absent or defective LDL receptors;
accelerated atherosclerosis

high blood levels of LDL and cholesterol

Question 13

AD

hypertriglyceridemia can cause pancreatitis

Answer 13

type IV familial dyslipidemia - hypertriglyceridemia;
hepatic overproduction of VLDL

high blood levels of TG and VLDL

Question 14

Function of MTP - microsomal triglyceride transfer protein

Answer 14

chaperone for apo B and helps with lipid transfer to new chylomicrons and VLDL;
defective in Abetalipoproteinemia (AR)
very low VLDL, chylomicrons, absent apoB –> poor lipid absorption, acanthocyte RBCs, vitamin deficiencies (E bc no essential FAs absorbed), progressive ataxia, retinitis pigmentosa, enterocytes with clear, foamy cytoplasm

Question 15

acanthocyte RBCs, vitamin deficiencies (E bc no essential FAs absorbed), progressive ataxia, retinitis pigmentosa, enterocytes with clear, foamy cytoplasm

Answer 15

Abetalipoproteinemia (AR)

loss of MTP fx or gene

Question 16

Lipoteichoic acid unique to

Answer 16

gram positive organisms

induces TNF and IL-1

Question 17

What parts of the cell’s exterior are unique to gram negative organisms?

Answer 17

Porin in cell wall;
Endotoxin/LPSs on cell wall exterior (antigenic outer membrane proteins “OMPs”);
Periplasmic space in between thin peptidoglycan cell wall and inner cell membrane - where beta-lactamase is found

Question 18

Gram negative sphere besides Neisseria

Answer 18

Moraxella catarrhalis

Question 19

Give 3 examples of Giemsa staining organisms

Answer 19

Chlamydiae
Ricketssiae
Borrelia
Trypanosoma (NOT treponema)
Plasmodium

Question 20

Legionella, Rickettsia, Chlamydia, Bartonella, Ehrlichia, Anaplasma, have in common?

Answer 20

Primarily intracellular

Chlamydia lack classic peptidoglycan because low in muramic acid (mermaid)

Question 21

India ink or mucicarmine stain for

Answer 21

Cryptococcus neoformans

Question 22

3 other organisms that silver stain identifies besides legionella

Answer 22

Coccidiodes, PJP, Heliobacter pylori

Question 23

“Very Typically Cultures Neisseria”

Answer 23

Thayer-Martin agar - selective media

Vancomycin, Trimethoprim, Colistin, Nystatin

Question 24

“Bordet for Bordetella”

Answer 24

Bordet-Gengou agar
Rean Lowe medium
for Bordatella pertussis isolation

Question 25

Loffler medium for

Answer 25

C. diphtheriae (also Tellurite)

Question 26

Eaton agar for Mycoplasma requires

Answer 26

cholesterol

Question 27

Lowenstein-Jensen agar for

Answer 27

M. tuberculosis

Question 28

Legionella requires charcoal yeast extract buffered with

Answer 28

cysteine and iron

Question 29

Sabouraud agar for

Answer 29

fungi

Question 30

What antibiotics are ineffective against anaerobes because they require O2 to enter the bacterial cell/

Answer 30

Aminoglycosides

Question 31

"Some Nasty Bugs May Live FacultativeLY"

Answer 31

``` Salmonella Neisseria Brucella Mycobacterium Listeria Francisella Legionella Yersinia pestis ```

Question 32

LPS induces what three effects?

Answer 32

Macrophage activation (TLR4) - -> IL-1, IL-6 --> fever - -> TNF-alpha --> fever, hypotension - -> NO --> hypotension Complement activation - -> C3a --> histamine release, hypotension and edema - -> C5a --> neutrophil chemotaxis Tissue factor activation --> coagulation cascade --> DIC

Question 33

Pyrrolidonly arylaminidase (PYR) positive

Answer 33

Strep pyogenes | Enterococcus

Question 34

Fidaxomicin for

Answer 34

recurrent C. Diff

Question 35

Elek test to identify

Answer 35

toxin in diphtheriae | black colonies on cystine-tellurite agar

Question 36

Treatment for Actinomyces

Answer 36

Penicillin

Question 37

Treatment for Nocardia

Answer 37

TMP-SMX

Question 38

Azithromycin prophylaxis in AIDS patients with CD4

Answer 38

Mycobacterium avium-intracellulare

Question 39

H2S production on TSI agar

Answer 39

Salmonella | Proteus

Question 40

What is the key defining cell of granulomatous inflammation?

Answer 40

Epitheloid histiocyte (macrophages with abundant pink cytoplasm)

Question 41

What is the histologic hallmark of Crohn disease?

Answer 41

Non-caseating granuloma

Question 42

What is the histologic hallmark of Ulcerative Colitis?

Answer 42

Crypt abscesses - neutrophils in the bottom of crypts

Question 43

Most common type of thyroid carcinoma

Answer 43

Papillary carcinoma

Question 44

Second most common thyroid cancer

Answer 44

Follicular carcinoma

Question 45

Thyroid carcinomas that involve activation of receptor tyrosine kinases

Answer 45

Papillary and medullary carcinomas | RET proto-oncogene

Question 46

Hashimoto thyroiditis is a risk factor for

Answer 46

B cell lymphoma

Question 47

Cancer arising from parafollicular C cells

Answer 47

Medullary carcinoma

Question 48

Cancer commonly associated with either a RAS mutation or a PAX8-PPAR gamma 1 rearrangement

Answer 48

Follicular carcinoma

Question 49

Cancer commonly associated with rearrangements in the RET oncogene or NTRK1

Answer 49

Papillary carcinoma

Question 50

Most common mutation in the BRAF gene results in

Answer 50

Papillary carcinoma

Question 51

MOA Propothoiuracil

Answer 51

Inhibits peripheral conversion of T4 to T3; inhibits thyroglobulin to diiodotyrosine in the follicle NOTE: PTU and Methimazole can both cause aplastic anemia

Question 52

What cholesterol labs are elevated in hypothyroidism?

Answer 52

LDL and total cholesterol