multisys Flashcards by Hassan Khokhar

worsening arthritis of the left knee.
apt 50 sec
BT normal
Pt normal

hemophilia A … factor VIII…. XLR ….

remember factor VII is extrinsic …. PT is more extr

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bleeding … normat apt … increased PT

factor VII

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Presence of antiphospholipid antibody levels

lupus

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vWF disease findings

BT would increase … vWF is used for platelet adhesion

apt increased …. vwf is carrier of factor VIII

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prophylaxis for hep b infection is ?

hepb antibodies … which is passive immunization

just like igG from the mother to fetus

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passive immunization is used for

To Be Healed Very Rapidly 
Tetanus
Botulism
HepB
Varicella
Rabies

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noncoding repetitive neucleotide sequences at the end of the chromosome

telomreres…. maintain chromosomal integrity

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AT rich sequences, TATA and CAAT boxes

recognized by RNA polymerase II or other transcription factors leading to transcription
PROMOTERS

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gold standard for HCV treatment

ribavirin

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side effects of ribavirin

hemolyitic anemia … remember ‘R’ … increased reticulocyte count

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what are the signs of hemolytic anemia in blood

when rbc damage… inc LDH…. low haptoglobin levels as the free hb binds to the haptoglobin

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immunized hep b pt shows

antiHbs

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window hepb

antiHbe and anti HBc IgM

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when can minors consent on their own ? <18

sex(birth control, STI, pregnancy)
drugs(substance abuse)
rock n roll ( emerg trauma)

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antibiotic that induces DNA damage in anaerobes

metrondazole

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antibiotic that inhibits 30s .. food borne illness

shigella

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consuming undercooked chicken could lead to infection with

salmonella … but symptms take 12-72 hrs

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homocystinuria can be caused by?

cystathione synthase def
vit b6 def
methionine synth def

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researcher’s beliefs, in this case in the efficacy of a treatment, changes the outcome of a study.

observer bias

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conclusion might be drawn about a population of people who chew gum in order to quit smoking and an increased incidence of lung cancer,
what could be the error?

confounding …. the real cause of cancer would be the smoking

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Drugs that inhibit IMP dehydrogenase negatively affect guanine synthesis

hep c drugs like

ribavirin

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Guanosine analogues that inhibit viral DNA polymerase

acyclovir

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HIV drugs that cause hyperglycemia and lipodystrophy

protease inhibitors … navirs

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nucleic acid fragment is added to a tube along with a polymerase, a primer, and deoxyribonucleotides. The tube also contains the four bases as fluorescently labeled dideoxynucleotides. The products in the tube are then run through a capillary, and a laser detects the fluorescence of the products that come out of the capillary

process is called sequencing

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tumor suppressor gene on the short arm of chromosome 3

``` VHL... AD Hemangioblastoma (retina,brainstem,cerebellum,spine) Angiomatosis Renal cell carcinoma Pheo ```

patient presents with a slowly spreading rash, decreased energy, anorexia, fever, and hepatomegaly. puppy,child, rash, no allergies

toxocara canis | visceral larva migrans …. increased eosinophils

upregulation of eosinophils in this process is mediated by interleukin

IL 5

JW parents deny blood transfusions for a dying child what do u do

GIVE BLOOD …. parents do not have the authority to deny life saving treatment for their child

A root cause analysis (RCA

identify the causal factors that underlie the failure and identify methods to prevent recurrence

Drug utilization reviews (DURs)

URs serve as a means of improving the quality of patient care, enhancing therapeutic outcomes, and reducing inappropriate pharmaceutical expenditures.

Failure mode and effect analysis (FMEA)

process applied before process implementation to prevent the occurrence of failure

defect in protein tagging in the Golgi complex

I cell disease | no tags means cant be sent to lysosomes so instead they get excerted extracellularly

defects in the breakdown of glycosaminoglycans.

hurler and hunter hunter has no corneal clouding (iduronate 2 def) XR hurler (L iduronidase ) def

stranger anxiety and should be able to roll over, hold a sitting position unassisted, pass toys from hand to hand, and babble.

6 months

at 3 months child can

hold head up (devp at 1 mont) | cant roll over or sit

kick a ball and should have a vocabulary of 200 words with the ability to form 2-word sentences. A child at this age should also be climbing stairs feed himherself with spoon/fork

24 months

arly-onset joint pain and stiffening, skin hyperpigmentation, limited range of motion of the large joints, and a systolic murmur in the aortic area.

alkaptanuria | homogentisate oxidase def …… blocks tyrosine to fumarate pathway

structure(s) is most likely avoided by inserting the needle at the midaxillary line along the upper border of the 10th rib

LUNG void lung injury, the needle must be inserted into the costodiaphragmatic recess between the 8th and 10th ribs at the midaxillary line.

CCA on tRNA

can carry amino acids ….. AA is covalently bound here to the 3' end

deficiency in ß-glucocerebrosidase and is most prevalent in members of the Ashkenazi Jewish population hepatosplenomegaly, aseptic necrosis of the femur, and bone crises.

gaucher

finding in gaucher

crumbles macrophages

mental retardation, cherry-red maculae, and “foamy” macrophages hepatosplenomegaly

neiman pick

n addition to GLUT transporters, utilize SGLT glucose transporters

enterocytes and nephrons

RSA resists β-lactams by

altering PBP ... penicillin binding proteins.. transpeptidases

trisomy in downsyndrome happens when

mostly in anaphase of meiosis I or II

heriditary fructose intolerance ...

diarrhea ... watery aldolase B def no cataracts accum of fructose 1 phosphate ... that inhibits gluconeogensis

anti cardiolipin antibodies are found in syphilis ... where is cardiolipin found

inner mitochondrial membrane

a useful tool to help guide the root cause analysis

fishbone diagram

opiod toxicity ,,, respiratory acidosis ... what is the body's first reaction to buffer the H+

excess H+ enters cells and binds the intracellular proteins

which step uses biotin in gluconeogenesis

pyruvate to oxaloacetate

antifungal that binds tubulin

griseofulvin

when is RhoGHAM given

it is given to the mother who is RH - with Rh + child ... it is to prevent sensitization vs the Rh antigen in the blood

bright red rash 2 days after having a fever, a headache, and diarrhea. He has not had any change in appetite, cough, shortness of breath, or sore throat. erythematous reticular extensive rash

fifth disease parvo B19 self limting

pleitrophy

single mutation has diverse effects on different organs example PKU

locus hetrogeneity

different mutations present same phenotype | ex; marfan homocystinuria MEN2B

mean

negative skew | tail of the curve is where the

diabetic mother ... child has loud S2 ... blood from right ventricle seen in systemic circulation

failure of aorticopulomnary septum to spiral.. transp of greater vessels

defect in septum primum

ASD in down syndrome

hospice care covered by which medicare

test of antigen-antibody hybridization that is used to detect an antigenic match in a patient’s blood sample to determine if a person’s immune system has encountered a particular antigen.

Elisa

protein-antibody hybridization to detect protein

westernblt

most abundant form of rna

rrna

young healthy girl ,,, main concern is cheaper monthly insurance plan

HPO

birebeck granules activate which type of immune respnse

they are APC in the skin ... they present MHC2 ---- activate TH4 cells

APC that present MHC1 | and which cells do they activate

MHC 1 is present on all cells except RBC | activate natural killer cells

capping

occurs at the 5’ end of the mRNA - regardless of the sequence - and acts to stabilize the mRNA for export from the nucleus.

transcription

is the process of RNA synthesis from a precursor DNA template

polyadenylation

is the addition of adenosine to the 3’ end of the initial RNA transcript and functions as stability for nuclear export.

a 5’ GU --- AG 3’ sequence serves as a site for?

splicing

which blood disorder is affected by splicing

B thalassemia

marathon runner sweats .. what glands and thru stimulation of?

eccrine ... thermoregulatory glands... sympathetic stim

influenza vaccine response

humoral response against hemaglutinin | hem helps virus bind cells

how to block an anaphylaxis shock

target immunoglobulin surface receptor | disrupt the cross linking

topical antibiotic form commonly used OTC but not used systemically coz of toxicity

bacitracin | inhibiting translocation of the D-ala-D-ala peptide from inside to outside the bacterial cell.

involves DNA transfer from infection of a virion, which is packaged with DNA from another bacterial cell.

transduction

is a process through which naked purified DNA (DNA outside any cell exposed in the environment) is taken up by bacteria and incorporated into the chromosome.

transformation

muscle biopsy showing deficiency or absence of the enzyme myophosphorylase.

type V mcARDLE

Liver biopsy revealing deficiency of phosphorylas

Hers disease type VI | hepatomegaly and growth retardation

Muscle biopsy showing a deficiency of debranching enzyme

IIIa Cori disease solely outside skeletal myocytes, including the liver and heart, leading to early symptoms, including hepatomegaly, growth retardation, muscle weakness, hypoglycemia, hyperlipidemia, and elevated liver transaminase levels.

Muscle biopsy revealing a deficiency of lysosomal α-glucosidase

Pompe | glycogen buildup in cardiomyocytes

Muscle biopsy revealing deficiency of phosphoglycerate kinase

muscle weakness, neurological symptosm, anemia | due to decreased pyruvate

enveloped -ssRNA linear virus | child has a rash runny nose cough

rubeola measles

enveloped +ssRNA lineaer virus

Rubella | fever occurs 1-5 days before the rash

gram-negative coccobacillus

bordtella pertusis | ADP ribosylation of Gi

the palmar skin has an additional layer which is it

lucidum

Mutation in the penicillin-binding protein

mechanism of resistance for VANCO

cyclic fever headaches and general weakness.. hepatosplenomegaly after travel MRI shows cerebral edema and pt has seizures

malaria | p.falciparum has cerebral involvmnt

what is different in inf with p.malaria

more regular 72 hour cycles

the sand fly and may cause spiking fevers and hepatosplenomegaly

leishmania donovani

meeting with all healthcare professionals involved in surgeries to discuss ways to minimize potential errors that would result in harm to the patient.

swiss cheese model | think "S" ... system safetyyyy

onvulsions, hyperirritability, peripheral neuropathy and sideroblastic anemia vitamin def

B6 pyridoxine

adrenal insufficiency along with enteritis and dermatitis | vitamin

B5 Pantothenic acid

cheilosis, corneal vascularisation, and seborrheic dermatitis.

B2 riboflavin

Lipid and membrane biosynthesis

smooth ER

Degradation of cellular material

lysosomes

β-Oxidation of long-chain fatty acids

peroxisome

golgi apparatus

protein modification

defect in the CD40 ligand on CD4 T-helper cells.

hyper IgM syndrome

efect in nicotinamide adenine dinucleotide phosphate oxidase

CGD | increase risk of infc with staph nocardia pseudo listeria

non motile gram negative bacterium

shigella

mechanism of shigella infection

infects M cells in peyers patches

facial features have developed abnormally. hyperactive and aggressive. Physical examination reveals a prominent forehead; an enlarged tongue; hepatosplenomegaly; and several pearly, papular skin lesions over the scapulae, lateral upper arms, and thighs.

Hunter iduronate sulfatase rmmber hunters are aggressive***

peripheral neuropathy, angiokeratomas, and hypohidrosis

fabry | alpha galactosidase

oagulase-negative Staphylococcus species, such as S. saprophyticus and S. epidermidis, are associated with infection.

foley catheter