May 11th Flashcards
(103 cards)
1
Q
multinucleated giant cells with intracytoplasmic AND intranuclear inclusions
A
Warthin-Finkeldey giant cells (fused lymphocytes)
Respiratory secretions
Measles
2
Q
Most common causes of common cold
A
1- rhinovirus
2- coronavirus
3
Q
Immune complex is what type of sensitivity
A
Type 3
4
Q
CMV retinitis
A
Common cause of blindness in AIDS
Cotton-whool exudates, perivascular hemmorhage, retinal detachment
5
Q
Mitral stenosis
A
Late diastolic murmur,
Best heard at apex
6
Q
PAndemic vs epidemic
A
Pandemic: segmented virus, antigenic shift.
Epidemic, mutations, drift
7
Q
S3 gallop
A
Dialated cardiomyopathy
8
Q
De Quervain thyroiditis
A
Transient hypothyroidism following viral illness
Tender thyroid, elevated erythrocyte sedimentation and hypothyroid
EBC, Coxackie, flu, adeno
9
Q
Varicella roster pathology
A
Cordry A inclusion bodies. Intracellular eosinophilic sorrounded by halo
10
Q
Bactrim MoA (TMP-SMX)
A
Inhibits bacterial dihydrofolate reductase
Causes megalobalstic anemia
11
Q
Premature baby risk
A
Bronchilitis caused by RSV
Wheezing bc bronchiole (vs pneumonia which is lung parenchyma)
12
Q
Alcoholics have increased emzyme:
A
AST vs ALT (but both)
Gamma glutamyl transferase
13
Q
Spindle shaped tumor
A
Kaposi sarcoma
14
Q
Regan-lowe
A
Bordetella pertussis
Also bordet-gengoug
15
Q
Ventilator associated pneiu==ymonia
A
Pseudomonas
16
Q
CMV vs EBV owl eyes
A
EBV: reedsternberg, clear cells in lake (higher C:N ratio)
CMV: owl eyes, immediate halo. Owl eye.
17
Q
Why dont IgG for hep C get rid of diseasse?
A
Antigenic variation. No proofreading 3’ to 5’
18
Q
Aniline dyes
A
Methylene blue (stains orynebacterium diptheriae)
19
Q
How do sufur granules look in histo
A
Purple plaque
20
Q
Von Girk
A
Deficiency in glucose-6-phosphatase
Seizures, hypoglycemia
Hepatosplenomegaly
21
Q
Define asterixis
A
Flapping whne outstretched hands
Suggestive of high ammonia levels
22
Q
Where is ammonia broken down?
A
Initial steps: mitochonidrai
Late steps: cytoplasm
23
Q
Duchennes
A
Frameshift mutation
Accelerated muscel breakdown, starts pelvis works up.
GOWER’s manuver
X linked
24
Q
Toxicity of statins
A
Elevated creatine kinase
Rhabdommyolosis
Myostitis (muscle inflammation)
25
Cyanide poining
Bright red vessels in eyes
Bitteralmond breath
Fatigue
From fire/constructoin
26
Isonaiazid
Treatment/prophylaxis for TB
| Causes neurotoxicity and heptotoxicity
27
Kartagener's
Chornic sinusistis, bronchiectasis, situs inversus (mirror body organs)
Dyenin deficiency
28
Elevation of leucine, isoleucine, or valine in blood (
I Love Vermont
Maple syrup disease
Alpha ket acid dehydrogenase
29
Alcohol effect on NADH/NAD
Increased NADH: NAD ratio
| NAD is used p.
30
Vitamin C
Hydroxylation of proline lysine
| Facilitates iron obbsorption
31
Reyes syndrome
Impaired mitochondrial metabolism of fatty acid
| Virus + aspirin
32
Hunter syndrom
Xlinked recessive
Intelectual disability, hearing loss, coarse face, hepatosplenegaly
And NO corneal clouding
Iduronate sulfatase
33
Ovoid cells within macrophages
Histoplasma capsulatum
34
Diabetic mononeuropathy
Usually CN III, ischemia of somatic, but spares parasympathetic.
"Down and out" gaze.
Normal reflex
35
Kidney stone pee
Hematuria
| Normocacemia BUT hypercalciuria
36
Antifungal target:
```
Mitosis: griseofulvin
DNA/RNA synthesis: flucytosine
Cell wall: caspofungin
Cell membrane:
-amphoteracin, nyastatin (bind ergosterol)
-azoles inhibit ergosterol synthesis
```
37
Type 1 hypersensitivity
```
Immediate
IgE
Anaphylaxis/allergies
Basophils, mast cells.
"Cell surface antibody bridging by antigen"
```
38
Type II hypersensitivity
Cytotoxic, IgG, IgM (deposits)
Complement activation.
NK, eosinophil, neutrophil, macrophage
Goodpasture, autoimmune hemolytic anemia
39
Type III hypersensitivity
Immune complex
Neutrophil
Complement activation
40
Type IV hypersensitivity
Delayed type
T cell, Macrophage (no humoral).
TB skin test
41
Leukocyte ahesion cascade
Margination: bloodflow
Rolling: P/E selectin (cell) + Integrin/sialyated glycoprotein (cell)
Activation: ICAM-1 (integrin ligand)
Tight adhesion: CD18
Transmigration: PECAM1 (platelet endothelial adhesion molecule
42
What cell can't use ketones
RBCs. No mitochondria
43
How do you treat muscle stiffness/tremor associated with antipsychotics?
Anticholinergic AND stop meds
44
Most common cause of death after MI
V-Fib
45
CO/End diastolic volume curve
X intercept = mean systemic pressure
| Decreased total peripheral resistance = Increased slope of both Cardiac functiona nd venous return curve.
46
L2
Sensory loss: upper thigh
| Weakness: hip flexion
47
L4
Patellar Reflex
48
S1
Achilles reflex
49
Third nerve crosses
Between posterior cerebral and Superior cerebral arteries
50
Aneurysm from posterior cerebellar or posterior cerebral
Ipsilateral headache, diplopia, nonreactive pupil, ptosis, and down and out eye.
Smoking and hypertension
51
Estrogen on thyroid
Less clearance of thyroid binding protein
Low free T4 for a little, then TSH makes more so free is equal.
Long term = increased TOTAL thyroid
52
Diagnosing cholecystitis
Prefereed: ultrasound
| Nuclear medicine scanning: more specific
53
Age related macular degeneration (AMD)
Smoking makes wors.
Dry: gradual vision loss in one or both eyes. Difficulty reading/driving. Drusen depsoits (yellow spots on fundescopic). VEGF
Wet: acute vision loss, metamorphosia (distrotion of straigt lines). (Ray/green subretinal discoloration.
54
Abortion
Misoprostol: prostaglandin E1 agonist
Mifepristone: progesterone/glucocorticoid antagonist
Methotrexate: Folic acid antagonist
55
Effect modification
Effect of an exposure on an outcome is modified by another variable (Drug)
Vs. confounding, when coincidentally something was not thoguht of.
56
alpha 1 antitrypsin deficinency (AAT)
Destruction by macrophages of alveolar walls.
| Unsecretted AAT is seen within periportal hepatocytes as reddish-pink with acid-schiff.
57
Trisomy 21 in utero
Low alpha feto protein (AFP) and unconjugated estriol
| Increasedb-hCG and inhibin A
58
Cardiac output calculation
CO = stroke vl X heart rate
Or
CO= rate of O2 consumption/ AV O2 difference
59
Serotonin amino acid precursor
tryptophan
60
How to treat serotonin syndrome
Antagonist (crypoheptadine)
61
Xanthelasma
Yellow macule/laque on eyelid
| Hyperlipidemia
62
Hypoketotic hypoglycemia
Acyl CoA dehydrogenase deficiency (Acyl CoA to acetyl CoA from fatty acids)
Ketones: acetoacette
63
Centriacinar emphysema
```
Smoking history
Exertional dyspnea
Dialated airspaces on CT
Wheezes
Infiltrating neutrophil
```
64
Kidney embryo origin
Ureteric bud: collecting system (ureter, calyces, collecting tubules/ducts)
Metanephric mesoderm: glomerulus, distal and proxuimal tubules.
65
IL12 deficiency
Can't make Th1, must treat with IFN-y
66
Benzodiazepine MoA
Bind to bendodiazepine binding site, allosterically modulates biding of GABA.
Increases frequency of ion channel opening.
67
Marker in Glomerulonephritis
Serum IgG antibodies to PLA2R (found in glomerular podocites).
68
Paroxysmal nocturnal dyspnea
Marker of no DAF (CD55).
| Heme cells attacked by IgG and complement
69
Why dont calcium channel blockers block skeletal muscle?
Does not require extracellular calcium influx for excitation/contraction coupling
70
Why is elastin rubber-like?
Because of elastin monomer cross-linking
Lysyl oxidase (requires copper). lysine common.
Desmosine cross-liinks
71
Homocysteinuria
No methionine synthase (B12) or cyastathionine synthase (B6).
Can't make cystine from homocystine. Elevated methionine.
72
Big sideffect of ganciclovir
Neutropenia (bone marrow suppression). Worse if you give zidovudine or trimethroprim-sulfamethoxolate
73
Define dysarthria
Weak muscles, resulting in slurred speech.
74
Wallerian degeneration
Breakdown of axon distal to site of injury.
B/c BBB, macrophage recruitment is slow
Plaque forms, prevents axonal growth. Glial scar. Persistant myelin debris
75
Chemicals in insulin metabolic acidosis URINE
Decreased pH (b/c HCO3 is removed to balance pH)
Decreased HCO3
Increased H2PO4- (to trap H+ for excretion)
76
Hydrocele occurs where?
Inside tunica vaginalis
77
S3 in adults
Limitation of ventricular movement during passive filling
| Ventricular enlargement
78
When can S3 be heard best?
Left lateral decibitus at END expiration
79
Attrition bias
Form of SELECTION bias
| people leaving study
80
Dangerous consequence of Adenosine and dipyridamole?
Cardiac steal (bc they are vasodilators) from ischemic sections. Blood flows in least resistance.
81
Hyaluronic acid
Present in strep pyogenes
NOT IMMUNOGENIC
Bc also present in connective tissue
82
How do you better facilitate phagocytosis of strep pyogenes?
Add antibodies to protein M (virulence factor).
83
Pulmonary embolism in breathe tests
Ventilation/perfusion mismatch
| Leads to hypoxemia
84
Ipratropium MoA
Blocks acetylcholine at muscariinc receptors
| Prevents bronchoconstriciton, reduces parasympathetic stimulation
85
Feeds descending colon
Inferior mesentaric artery
| Feeds all hindgut (distal 1/3 of transverse, descending, sigmoid, rectum)
86
Risk for galstone formation
High cholesterol
| Low bile salts or phosphatidylcholine (both increase solubility)
87
Pigmented gallstones
Calcium and unconjugated bilirubin
Usually secondary to bacterial (salmonella) or helminthic (chlonorchis sinesis) infection OR hemolytic anemia
Causes release of beta-glucuronidase by injured hepatocytes (increased unconjugated bilirubin)
88
Gemfibrozil MoA
Fibrate, reduces cholesterol solubility (so it's not absorbed)
Risk: can cause gallbladder stones (don't give w/ history)
89
Drug use for seizures
Absence: valproic acid/ethosuximide
| Combined absence and tonic cloinic: valproate.
90
Stop drinking drugs
Stop pleasure: Naltrexone
| Once you stop drinking to stay sober (disulfram)
91
Gonadal arteries arise from
Abdominal aorta, right under renal arteries
92
HIrschprung
Failure of neural crest migration to intestinal wall.
No meissner or myenteric plexus.
Check submucosa of the rectum (narrowed part)
93
Pheochromocytoma presentaton
```
Episodic headache
Tachycardia
Diaphoresis
HTN, severe.
(Catecholamine secreting tumor from chromaffin cells)
```
94
Completely opacified hemithorax
Looks like pleural effusion BUT shortness of breath mixed with tracheal deviation TOWARD problem = collapse.
Likely mainstrem bronchi lesion/occlusion leading to collapse
95
How to treat carcinoid syndrome
Octreotide
| diagnosed by increased 5-HIAA urine excretion
96
Most common kidney issue in SLE
Diffuse progressive glomerulonephritis
| Proteinuria
97
Treatment for SLE
```
Skin/muscle: hydroxychloroquine
Organ involvement (nephritis): cyclophosphamide
```
98
Langerhans cell histoicytosis
Disorder of dendritic cells (langerhan cells)
Present in kids 1-3 as lytic bone lesion, skin rash or recurrent otitis media. Jaw mass.
Tennis racket sapedBirbeck granules on EM
99
Leukocyte adhesion defieicency (LAD)
No neutropihl going into periphery. High in blood, no pus in infection.
Absence of CD18 integrin.
100
Anti IgG antibodies are pathomneumonic for what?
Rheumatoid arthritis
101
Rheumatoid arthritis
Rheumatoid factor (anti IgG)
Fatigue, chroinic joint pain not made better by tylenol.
Bilateral hands and knees
Stiffness that improves with movement.
102
Acute lymphocytic leukemia
3-7
Fever, atigue, decreased appetite, night sweats
Cervical lypmohadenopathy, anemia, petichial rash
>20% leukemic blasts
103
Job syndrome
```
Hyper IgE (Th17 can't make IL18, no neutrophil)
FATED
Faces weird (coarse, leathery)
Abscess (cold)
T: Baby teeth retained
E: IgE is high
D: derm (excema)
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