Intersystems

Question 1

what family is HIV? what typeof nucleic acid?what receptor does it bind to on entry? where is replication? where is assembly?

Answer 1

retrovirdae, ss RNA. binds to CD4 receptor on entry, replicates in nucleus, assembles in cytoplasm.

Question 2

2 HIV proteins he didnt shut up about? what are they involved in

Answer 2

TAT and REV. TAT involved in transcription. REV - Regulates Expression of Virion proteins

Question 3

name 3 ways HIV avoids immune response

Answer 3

high mutation rate, latency, altered antigen presentation

Question 4

4 targets for anti HIV drugs

Answer 4

fusion/entry inhibitors, reverse transcriptase inhibitors, integrase inhibitors, protease inhibitors

Question 5

where do most lesions arise from in breast path?

Answer 5

epithelium of the terminal duct lobular unit

Question 6

dif b/w fibrocystic change and fibroadenoma in breast path?

Answer 6

cyst = benign. multifocal and bilateral. fibrosis with cyst formation.
Adenoma = benign - usually in younger women. solitary well circumscribed mass. presents as lump

Question 7

define a carcinoma in situ. name the 2 types.

what are the 2 invasive carcinomas? which is more common

Answer 7

Malignant population of cells confined to ducts and/or acini, w/o invasion through basement membrane.
Ductal Carcinoma in Situ.
Lobular Carcinoma in Situ.

same as non-invasive. Ductal and lobular. Ductal much more common (D for Death).

Question 8

where are most of the accessory cells within the epidermis?

Answer 8

stratum basale

Question 9

skin circulation?

Answer 9

2 main plexuses.

Papillary plexus - Beneath papillary dermis.

Cutaneous plexus- At junction of dermis and hypodermis.

Question 10

where is the thickest skin

Answer 10

on back

Question 11

what type of cell is a merkel cell? role

Answer 11

neuroendocrine, somatosensory

Question 12

pain fibres of the peripheral nerve and their difs?

Answer 12

A delta = fast. C = slow

Question 13

3 organisms that transmit via airborne

Answer 13

TB, measles, Varicella

Question 14

type of virus is ebola? countries affected? how long til symptoms appear after infection? when and how can transmission occur?

Answer 14

Filovirus, Guniea, Sierra Leone and Liberia. 2-21 days. transmission only during clinical illness via body fluids

Question 15

definition of fever? when is temperature higher? optimum temp for immune response?

Answer 15

oral above 37.8 or morning above 37.2. Higher in afternoon. Optimum temp for immune is 39.5

Question 16

4 differentials for PUO

Answer 16

infection, connective tissue disorder, malignancies, other (drugs)

Question 17

in which disease can Pseudomonas Aurigenosa be potentially more virulent

Answer 17

Cystic Fibrosis

Question 18

which common superficial places can Pseudomonas Aurigenosa infect (2)?

Answer 18

skin: wound infection or ottitus externaeye: keratitis(cornea)

Question 19

how do biofilms aid bacterial survival?

Answer 19

resist mechanical removal and are less visible to the innate immune system

Question 20

most common cause of fungal meningitis?

Answer 20

cryptococcosis

Question 21

what do dermatophytes cause?

Answer 21

tinea

Question 22

where is candida albicans carried in the body (2)

Answer 22

gut and vagina

Question 23

which virus is associated with lymphomas

Answer 23

EBV

Question 24

name 3 risk factors for lymphomas

Answer 24

immunosuppresion, some autoimmune diseases (hashimotos) and EBV

Question 25

4 eye problems affecting indigenous people

Answer 25

trachoma. cataracts, diabetes, refractive error

Question 26

explain what does trachoma cause? how can it be prevented

Answer 26

repeated infections causes blindness. can be treated with good facial hygiene.

Question 27

3 ways venom causes death. explain each

Answer 27

1. haemotoxicity - can contain a v powerful pro coagulant → localized clotting → strips the body of clotting factors (fibrin) → vulnerable to catastrophic bleed. Can also can also be a very powerful anti-coagulant → vulnerable to catastrophic bleed. 2. neurotoxicity - paralysis 3. Myotoxicity - Rhabdomyolosis causing renal failure. (muscle breakdown > increase myoglobin > damage kidney)

Question 28

3 types of haemoglobinopathies - give an example

Answer 28

1. decreased/no synthesis of globin chains (a or b thalassemia). 2. Structural variation to Hb (sickle cell anaemia). 3. persistent fetal haemoglobin HbF (not clinical).

Question 29

genetic mutation for each of alpha, beta and sickle cell?

Answer 29

alpha = large deletion. | other 2 are point mutations

Question 30

symptoms of beta thalasseima? (4)

Answer 30

failure to thrive, anaemic, thinning of long bones & cranial bones(to make more blood cells) ,facial maxillary overgrowth Hepatosplenomegaly

Question 31

name 3 mechanisms for gene mutation

Answer 31

chromosomal translocation, point mutation and viral/bacterial

Question 32

Philadelphia chromosome is involved in which leukaemia? 2 chromosomes and genes involved

Answer 32

CML. 22;9 Bcr-Abl

Question 33

Gleevec (imatinib) is a treatment for which leukaemia? what is its MOA

Answer 33

CML. A specific Bcr-Abl tyrosine-kinase inhibitor

Question 34

BH-3 only mimetic ABT-199 is a drug in clinical trial for which disease?

Answer 34

CLL

Question 35

Main gene involved in CLL? what happens

Answer 35

Bcl-2 - over-expression prevents apoptosis

Question 36

miRNA(15,16), ZAP -70 and p53 involved with which cancer?

Answer 36

CLL

Question 37

Describe, using examples, how SNPs can change Pharmacokinetic and Pharmacodynamic behavior of drugs.

Answer 37

Kinetics - with statins - a SNP in one of the liver transport genes will decrease statin uptake and increase toxicity. Dynamics - SNP in the 5-lipoxygenase gene is predicitve of poor response to anti-luekotriene therapy in asthma

Question 38

describe why an opioid receptor agonist and antagonist may be combined

Answer 38

one for pain relief and one to prevent constipation

Question 39

what happens in folliculitis and what is most common cause?

Answer 39

blockage of hair follicle caused by Staph A

Question 40

S. aureus produces a vast array of virulence factors to enable it to overcome immunity. name 5

Answer 40

1. Binds to damaged tissues via adhesins 2. inhibits chemotaxis 3. Inhibits phagocytosis 4. If ingested by PMNs, can resist killing 5. forms biofilms

Question 41

key feature that differentiates CA-MRSA from HA-MRSA

Answer 41

CA-MRSA has the gene for PV-leukocidin

Question 42

M protein is a virulence determinant associated with which organism

Answer 42

GAS

Question 43

what is a NET? which bacteria can overcome this and how

Answer 43

Neutrophil Extracellular Trap - the neutrophil essentially forms a net of DNA arround the organism. GAS can overcome this with a DNAse

Question 44

what kind of trauma is pseudomonas infection likely to result (2)

Answer 44

diabetic foot ulcer and burn

Question 45

how much blood is made? how often

Answer 45

red cell 3-5 x 10^12 p/L. 120 days White 2-6 x 10^9 p/L. 3-5 days Platelets 150-400 X 10^9 p/L. 10 days

Question 46

sites of Haemopoiesis throughout life

Answer 46

Yolk Sac - first few weeks. Liver and spleen - 6weeks-7 months. Bone marrow - 7 months- throughout life

Question 47

name 3 haemantics

Answer 47

iron, B12, folate

Question 48

non anaemic sign of iron defficiency

Answer 48

pica

Question 49

components of a RBC (3)

Answer 49

membrane, haemoglobin, enzymes

Question 50

single most important physiological equation related to blood? Measurements

Answer 50

Tissue oxygen delivery = CO x Hb x %sat x 1.34. | l/min x g/l x % x mls/g = mls/min

Question 51

anaemia is defined...

Answer 51

Hb levels below that which is normal for age and gender

Question 52

2 main reasons for microcytic anaemia, one for child and one for adult

Answer 52

iron defficiency (diet) and blood loss (colon cancer)

Question 53

lack of B12 or folate can cause macrocytic anaemia, why?

Answer 53

they needed for DNA replication. cells grow big coz cannot produce DNA quickly enough to divide at the right time