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Bacteria that don't stain well
"These Rascals May Microscopically Lack Color"

These - Treponema
Rascals - Rickettsia
May - Mycobacteria
Microscopically - Mycoplasma
Lack - Legionella
Color - Chlamydia

1

Obligate Aerobes
"Nagging Pests Must Breathe"

Nagging - Nocarida
Pests - Pseudomonas aeruginosa
Must - Mycobacterium TB
Breathe - Bacillus

2

Obligate ANaerobes
"Can't Breathe Air"

(normal GI flora, NOT Tx w/ aminoglycosides)
Can't - Clostridium
Breathe - Bacteroides
Air - Actinomyces

3

Facultative Intracellular Microbes
"Some Nasty Bugs May Live FacultativeLY"

* Hard to get rid of!
Salmonella, Neisseria, Brucella (Some Nasty Bugs)
Mycobacterium, Listeria (May Live)
Francisella, Legionella, Yersinia (FacultativeLY)

4

Encapsulated Bacteria
"SHiNE SKiS"

=> + "Quellung rxn" *need spleen to clear these!*
S - Strep pneumo, Hi - H. influenza, N - Neisseria, E - E. coli
S - Salmonella, K - Klebsiella, (i), S - Strep grp B

5

Catalase + microbes
"you need PLACESS for you CATs"

*risk these inf. w/ Chronic Granulomatous Disease
Pseudomonas, Listeria, Aspergillus, Candida, E.coli, Serratia, S.aureus

6

Chlamydia serotypes:
"ABC"

serotypes A, B and C (all 3) = associated w/ infections in Africa which cause Blindness when Chronic (bc follicular conjunctivitis)
"A Africa, B blindness, C chronic"
*other serotypes (D-K) => urethritis, neonatal pneumonia/conjunctivitis, etc.

7

Systemic fungal infections
- Histoplasmosis
- Blastomycosis
- Coccidiomycosis

1. "Histo Hides" inside macrophages
2. "Blasto buds" (broad-based budding, same size as RBCs on smear)
3. "Coccidio crowds" - spherule w/ endospores is MUCH larger than RBCs on smear

8

"RIP Always" killed viral vaccines

*only induce humoral immunity*
R- Rabies
I- Injected influenza
P- Polio (Salk)
Always - hep A virus

9

Parvovirus = "part of a virus"

parvovirus is the only DNA virus that is ssDNA (SINGLE strand instead of double)

10

Polyomaviruses JC and BK
"Junk Cerebrum" and "Bad Kidney"

JC virus => Progressive Multifocal Leukoencephalopathy
BK virus => targets kidney in transplant recipients

(both = circular dsDNA viruses)

11

"repeato-virus" = reovirus, an RNA virus

Reovirus = the only dsRNA virus (all others = ssRNA)

12

Hypothalamus controls "TAN HATS"

T: Thirst/water balance
A: Adenohypophysis (ant. pituitary),
N: Neurohypophysis
H: Hunger, A: Autonomic regulation, T: Temperature, S: Sexual urges

13

Types of Aphasia
- "Broca's Broken Boca"
- "Wernicke's: wordy, What?"

Broca's aphasia: can understand but can't form speech correctly (brain problem, not mouth problem)
Wernicke's aphasia: can't comprehend --> lots of non-sensical speech

*Conduction aphasia: poor repetition (esp. of phrases)
= arcuate fasc. damage

14

Types of information carried by the 12 Cranial Nerves
"Some Say Marry Money But My Brother Says Big Boobs Matter More"

CN 1-12 in order,
S = sensory
M = motor
B = both

15

Sxs of Tuberous Sclerosis = "HAMARTOMAS"

findings in tuberous sclerosis:
Hamartomas in CNS/skin
Adenoma sebaceum (= cutaneous angiofibromas)
Mitral regurgitation
Ash leaf spots
Rhabdomyoma (heart)
[Tuberous sclerosis]
aut. dOminant
Mental retardation
renal Angiomyolipomas
Seizures

16

Segmented viruses
"BOAR"

B- Bunyaviruses (valley fevers)
O - Orthomyxovirus (influenza)
A - Arenaviruse (LCMV)
R - Reovirus (Rotavirus, Coltivirus)

17

Red flags for headache
"SNOOP4"

S - Systemic Sxs
N - Neuro Sxs (confusion, focal def.)
O - Onset = sudden
O - Old age
P (4): 1. Previous Hx, 2. Postural aggravation, 3. Precipitated by exertion, 4. Papilloedema

18

IV drug use & bacterial endocarditis
"don't TRI drugs"

w/ Hx of IV drug use, bacterial endocarditis most likely:
@ TRIcuspid valve,
from Staph aureus, pseudomonas, or candida

19

Fetal erythropoesis:
"Young Liver Synthesizes Blood"

Young - yolk sac 3-10 wks
Liver --> 6 wks - birth
Synthesizes - Spleen 15 - 30 wks
Blood - Bone Marrow 22 wk - adulthood

20

vEnodilators vs. vAsodilators effect on heart

vEnodilators decrease prEload
vAsodilators decrease Afterload (ie: hydrAlazine)

21

"RALS" for relation between L & R pulmonary aa & lung hilus

RA - Right pulm. a. = Anterior to R hilus
LS - Left pulm. a. = Superior to L hilus

22

"I ate(8) 10 eggs at 12"
for structures perforating diaphragm

IVC ("I") = T8
T10 => Esophagus ("eggs")
Aorta ("@") = T12 *also the thoracic duct & Azygous vein at T12*

23

"C3, 4, 5 keep the diaphragm alive"

Phrenic nerve (carries C3,4,5) = innervates the diaphragm

27

Acidosis or alkalosis??
Bicarb & Breaths = Basic!

Blowing off CO2 (hyperventilation) => respiratory ALKalosis
build up of Bicarb = metabolic ALKalosis
*if low pH, high bicarb must be a compensation*

28

Keeping the leukotriene functions straight:
"B 4 Bus and taxis"
"C 4 Constriction, E 4 Edema"

Leukotriene B4 = chemoTAXIS ("bus" = transport...)
Leukotrienes C4, d4, E4 = vasoCONSTRICTION & bronchospasm ("constriction") & increased vascular permeability ("Edema")

29

Picornaviruses:
"PERCH"

= ssRNA + viruses, NOT enveloped.
P- Polio
E- Echo
R- Rhino
C- Coxsackie
H- HepA

30

CREST syndrome vs. Diffuse Scleroderma (& assoc. Abs)
"C for CREST, Confined"
"S for Systemic sclerosis"

CREST - C - antiCentromere Ab, Confined to fingers & face (~benign)

Diffuse scleroderma - S - anti-Scl-70 Ab (aka anti-DNA topo I), systemic involvement, rapid progression (lungs, kidneys, heart & GI)

31

Bullous PemphigoiD vs. PemphiguS Vulgaris
D - @ dermal junction
S - along Sides, Slides off

Bullous PemphigoiD = IgG Abs against hemidesmosomes @ epidermal BM --> tense blisters, spares oral mucosa.

Pemphigus VulgariS = IgG Abs against desmoglein 3 in desmosomes of epidermis --> Flaccid blisters that Separate from dermis w/ touch (+ Nikolsky's sign)

32

interosseous muscles of hand
"DAB and PAD"

DAB: Dorsal interosseous mm ABduct fingers
PAD: Palmar interosseous mm ADduct fingers

33

Innervation of muscles of foot:
"PED, TIP"

PED: Peroneal n. Everts and Dorsiflexes => foot dropPED if injury
TIP: Tibial n. Inverts and Plantarflexes => can't TIPtoe if injury
(both originate from Sciatic n., L4-S3)

34

CREST syndrome -- Sxs = C, R, E, S, T

CREST = subtype of scleroderma *w/ anti-Centromere Ab. ~benign
C - Calcinosis
R - Raynauld's phenomenon
E - Esophageal dysmotility
S - Sclerodactyly (puffy, taut skin on fingers)
T - Telangiectasia

35

SLE (lupus)-associated problems:
"SOAP BRAIN MD"

S- serositis, O- oral/pharynx ulcers, A- arthritis, P- photosensitivity
B- blood disorders (leukopenia, hemolytic anemia, C1 compl. def.)
R- Renal (DPGN),
A- ANA+,
I- Immunoglobs (anti-dsDNA/Smith),
N- neuro (seizures/psychosis)
MD - Malar/Discoid rash

36

Path of the ureters:
"water under the bridge"

=> ureters travel UNDERneath the uterine artery and vas deferens

37

Causes of Increased Anion-gap Metabolic Acidosis:
"MUDPILES"

M - methanol
U - Uremia
D - Diabetic ketoacidosis
P - Propylene glycol
I - Iron tablets/INH
L - Lactic acidosis
E - Ethylene glycol
S - Salicylates (> 2 hrs after ingestion)

38

Causes of metabolic acidosis with NORMAL anion gap:
"HARD ASS"

H - hyperalimentation
A - Addison's disease
R - Renal Tubular Acidosis
D - Diarrhea
ASS: (drugs) Acetazolamide, Spironolactone, Saline infusion

39

Transitional cell carcinoma assoc. risks:
"Pee SAC cancer"

Transitional cell carcinoma = Urinary tract carcinoma (bladder, ureters, renal calyces and renal pelvis)
Risks:
Pee - Phenacetin
SAC - Smoking, Aniline dyes, Cyclophosphamide

40

Arrest of cycle in oocytes...
1. Arrest until Ovulation
2. Arrest until egg "Meets" sperm

1. oocyte arrest in PrOphase of meiosis I until just before Ovulation
2. oocyte arrest in METaphase of meiosis II until fertilization (aka "egg MET sperm")

41

Partial vs. Complete Hydatidiform mole
"Partial = Partial Pregnancy"
"Complete = Cancer risk"

Partial mole: 2 sperm & 1 egg (69 chrom.), rise in hCG similar to pregnancy, has Fetal parts!

Complete mole: 2 sperm & empty egg (46 chrom), HUGE rise in hCG, no fetal parts but risk Choriocarcinoma