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Picmonic Flashcards

1
Q

1st generation Celphalosporins

A
  1. Cefazolin 2.Cephalexin 3. Proteus Mirabilis 4. Klebsiella 5. E. coli 6. Gram +
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2
Q

2nd Generation Cephalosporins

A
  1. Cefoxitin
  2. Cefaclor
  3. Cefuroxime
  4. Proteus mirabilis, Ecoli, kebsiella, Gram + cocci, Haemophilus influenzae, Neisseria, Serratia, Enterbacter
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3
Q

3rd Generation Cephalosporin

A
  1. Cefotaxime
  2. Ceftriaxone
  3. Cetazidime
  4. Serious gram negative bacteria to other beta lactams
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4
Q

4th Generation Cephalosporin

A
  1. Increased activity against pseudomonas and gram positives
  2. Cefepime
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5
Q

Aminoglycosides

A
  1. Bactericidal
  2. Inhibit formation of initiation complex
  3. Cause misreading of mRNA
  4. Require O2 for uptake
  5. Use for gram negative rod infections
  6. Synergistic with B lactam antibiotics
  7. Nephrotoxicity especially when used with cephalosporins
  8. Ototoxicity when used with loop diuretics
  9. Teratogen
  10. Gentamicin, Amikacin, Tobramycin, Streptomycin
  11. Use neomycin for bowl surgery
  12. Resistance by transferase enzymes bye acetylation, phosphorylation and adenylation
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6
Q

Aminopenicillin Mechanism

A
  1. Broader spectrum
  2. Ampicillin and Amoxicillin
  3. Beta lactamase sensitive
  4. Combine with clavulanic acid
  5. Hypersensitivity reactions
  6. Ampicillin rash
  7. Pseudomembranous colitis
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7
Q

Aminopenicillin Uses

A
  1. Ampicillin, amoxicillin
  2. Enterococci
  3. Listeria
  4. Haemophilus influenzae
  5. E coli
  6. Salmonella
  7. Proteus mirabilis
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8
Q

Anemia Lab value for Iron Deficiency Anemia

A

Serum iron decreased

Transferrin increased

Ferritin decreased

% transferrin saturation decreased

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9
Q

Anemia lab values for Pregnancy and OCP use

A

serum iron normal

transferrin increased

ferritin normal

% transferrin saturation decreased

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10
Q

Anemia lab values for chronic disease anemia

A

serum iron decreased

transferrin decreased

Ferritin increased

%transferrin saturation normal

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11
Q

Anemia lab values for Hemochromatosis

A

serum iron increased

transferrin decreased

ferritin increased

% tranferrin saturation increased

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12
Q

Anion Gap metabolic acidosis

* MUDPILES

A

Methanol

Uremia

Diabetic Ketoacidosis

Paraldehyde

Isoniazid

Iron

Lactic Acid

Ethylene glycol

Salicylate

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13
Q

Antipseudomonal Penicillins

A
  1. Mechanism same as penicillin
  2. Ticarcillin, Carbenicillin, Piperacillin
  3. Extended spectrum
  4. Clinical use on antipseudomonas and gram negative rods
  5. Beta lactamase sensitive
  6. Use with clavulanic acid

7 Hypersensitivity reactions

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14
Q

Aztreonam

A
  1. Monobactam
  2. Resistant to beta lactamases
  3. Binds to penicilin binding protein
  4. Inhibit cell wall synthesis
  5. No activity on gram positives or anaerobes
  6. Use on gram negative rods
  7. Non allergenic to penicillin
  8. Synergistic with aminoglycodsidases
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15
Q

Beta Lactamase Inhibitors

A
  1. Often added to penicillin antiobiotics
  2. Clavulanic acid
  3. Sulbactam
  4. Tazobactam
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16
Q

Cephaloporin MOA and AE

A
  1. Beta lactam drug
  2. Inhibits cell wall synthesis
  3. Bactercidal
  4. Hypersensitivity reactions
  5. Vitamin K deficiency
  6. Increased nephrotoxicity of aminoglycosides
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17
Q

Chloramphenicol

A
  1. Bateriostatic
  2. Inhibits 50S peptidyltransferase activity
  3. Menigitis
  4. Anemia
  5. Aplastic Anemia
  6. Gray baby syndrome due to lack of UDP- glucuronyl transferase
  7. Resistance caused by plasmid encoded acetyltransferase
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18
Q

Clindamycin

A
  1. Bacteriostatic
  2. Binds 50S ribosomal subunit
  3. Blacks translocation
  4. Anaerobic infections above teh diaphragm
  5. Aspiration pneumonia
  6. Lung abscesses
  7. Can cause pseudomembranous colitis
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19
Q

Clostridium Difficile

A
  1. Gram positive
  2. Bacilli
  3. Anaerobe
  4. Diarrhea
  5. Clindamycin and ampicillin
  6. Toxin A enterotoxin

7 Damages brush border of gut

  1. Toxin B cytotoxin
  2. Damages cytoskeletal structure
  3. Pseudomembranous colitis
  4. Toxic megacolon
  5. Detect toxins in stool
  6. Detect toxins in stool
  7. Vancomycin
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20
Q

Digoxin Mechanism and indication

A
  1. Direct inhibition of NA K ATPase
  2. Indirect inhibition of Na Ca exchanger
  3. Increase Ca in cell
  4. Positive inotropy
  5. CHF
  6. Stimulate vagus nerve
  7. Decreased conduction at AV node
  8. Atrial fibrillation
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21
Q

Digoxin Toxicity

A
  1. Cholinergic (nausea, vomiting, diarrhea)
  2. Blurry yellow green vision
  3. Bradycardia
  4. Decreased QT
  5. Scooping on EKG
  6. T wave inversion
  7. Prolonged PR interval
  8. Arrhythmia
  9. Hyperkalemia
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22
Q

Ethambutol

A
  1. Blocks arabinoysl transferase
  2. Arabinosyl transferase polymerizes carbohydrates
  3. Carb polymers make mycobacterium TB cell wall
  4. Red/ green color blindness
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23
Q

Fluoroquinolones

A
  1. Floxacins, ciprofloxacin, moxifloxacin
  2. Inhibit topoisomerase II enzymes including DNA gyrase
  3. Bactercidal
  4. Gram negative rods
  5. Urinary tract infections
  6. Pseudomonas
  7. Neisseria
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24
Q

Foluroguinolones Toxcities

A
  1. Diarrhea
  2. Skin Rash
  3. Headache
  4. Damage to cartilage
  5. Tendon rupture in adults
  6. Myalgias in kid
  7. Teratogen
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25
Imipenem
1. Resistant to beta lactamases 2. Broad spectrum anaerobe 3. Gram - rods, gram + cocci 4. Must administer with cilastatin 5. Cilastatin is inhibitor of renal Dehydropeptidase I 6. Diarrhea, skin rash, seizures 7. Meropenem 8. Stable to dehydropeptidase I 9. Reduced risk of seizures (non seizure causing)
26
Isoniazid
1. Used to treat TB 2. Requires catalase peroxidase 3. Decreases mycolic acid synthesis 4. Fast vs slow acetylators 5. B6 deficiency 6. Neurotoxicity 7. Hepatotoxicity 8. Drug induced lupus
27
Macrolides
1. Bacteriostatic 2. Erythromycin, azithromycin, clarithromycin 3. Bind to 23 S rRNA of 50S subunit 4. Inhibit protein synthesis by blocking translocation 5. Gram positive cocci 6. Atypical pneumonia 7. Chlamydia 8. Resistance by methylation of 23 S rRNA binding
28
Macrolide Toxicity
1. P450 inhibitor 2. Prolonged QT 3. Diarrhea 4. Cholestatic hepatitis 5. Eosinophilia 6. Skin Rash
29
Metabolic Alkalosis
1. Diuretic use 2. Vomiting 3. Antacid 4. Hyperaldosteronism
30
Metronidazole
1. Bactericidal 2. Forms free radical toxic metabolites 3. Damages DNA 4. Giardia lamblia 5. Entaemoeba 6. Trichomonas 7. Anaerobe 8. Gardnerella 9. Metallic taste 10. Disulfiram like reaction with alcohol
31
Normal gap metabolic acidosis
1. Diarrhea 2. Hyperchloremia 3. Renal tubular acidosis 4. Glue sniffing
32
Penicillin
1. Gram Positives 2. Spirochetes 3. Bind PBPs 4. Block transpeptidase cross linking of cell wall 5. Activate autolytic enzymes 6. Bactericidal 7. Hypersensitivity reactions 8. Hemolytic anemia 9. Beta lactamase sensitive
33
Polymyxins
1. Cationic 2. Act like detergents 3. Bind to cell membranes of bacteria 4. Disrupt their osmotic properties 5. Use for resistant gram negative infections 6. Neurotoxicity 7. Renal tubular necrosis
34
Protein Synethesis Inhibitors
1. 30S inhibitors 2. Aminoglycosides 3. Tetracyclines 4. 50S inhibitors 5. Chloramphenicol 6. Clindamycin 7. Erythromycin 8. Lincomycin 9. Linezolid
35
Respiratory Acidosis
1. Hypoventilation 2. Increased PCO2 \> 40 3. Babiturates depress central respiratory center of brain 4. Opioids depress central respiratory center of the brain 5. Airway obstruction 6. Respiratory muscle weakness/ paralysis
36
Respirary Alkalosis
1. Hyperventilation 2. High altitude 3. Aspirin 4. Restrictive lung disease 5. Pulmonary embolism 6. Progesterone 7. Progesterone 8. Rib fracture 9. Anxiety
37
Rifampin
1. Mycobacterium TB 2. Blocks RNA polymerization 3. Haemophilus influenzae B 4. Leprosy 5. Meningitis 6. P450 inducer 7. Red-orange urin
38
Sulfa Drug Allergies
1. Sulfasalazine 2. Sulfonylureas 3. Thiazide diuretics 4. Acetazolamide 5. Furosemid diuretic 6. Celeboxib 7. Probenecid
39
Sulfonamides Mechanisms
1. Bacteriostatic 2. Gram + and - 3. Nocardia 4. Chlamydia 5. PABA antimetabolites 6. Inhibit dihydropteroate synthetase 7. Sulfamethoxazole 8. Sulfisoxazole 9. Sulfadiazine
40
Sulfonamides Toxicities
1. Hypersensitivity 2. Hemolysis of G6PD deficient people 3. Nephrotoxicity 4. Photosensitivity 5. Displace warfarin from albumin 6. Kernicterus in infants
41
Tetracycline drugs and uses
1 Doxycycline, Demeclocyline, Minocycline 2. Fecally eliminated (doxycycline) 3. Use in renal failure 4. Antidiuretic hormone antagonist 5. Chlamydia 6. Rickettsia 7. Borrelia Burgdoferi 8. Helicobacter pylori 9. Mycoplasma pneurmonia
42
Tetracycline Mechanism
1. Binds to 30 S to prevent attachment of aminoacyl tRNA 2. Limited CNS penetration 3. Divalent cations inhibit absorption 4. Must not take with milk, antacids, iron
43
Tetracycline Toxicities
1. Photosensitivity 2. GI distress 3. Teratogen 4. Discoloration of teeth 5. Inhibition of bone growth in children
44
Trimethoprim
1. Bacteriostatic 2. Inhibits bacterial dihyrdofolate reductase 3. Used in comboination with sulfamethoxazole 4. Causes sequential block of folate synthesis 5. Combination used for recurrent UTIs 6. Shigella 7. Salmonella 8. Pneumocystis jiroveci pneumonia 9. Decrease in red and white blood cells 10. Can be alleviated with leucovorin rescue
45
Vancomycin Mechanism
1. Bactericidal 2. Gram positive 3. Inhibits cell wall mucopeptide 4. Binds to D-ala D ala 5. Resistance with change to D-ala D-lac 6. Staph aureus 7. Clostridum difficile 8. Enterococci
46
Vancomycin Toxicity
1. Thrombophlebitis 2. Nephrotoxicity 3. Ototoxicity 4. Diffuse flushing called red man syndrom 5. Red man syndrome can be prevented with antihistamine 6. Red man syndrom can be prevented with slow infusion
47
11 Beta hydroxylase deficiency
1. Decreased cortisol 2. Decreased aldosterone 3. Increased sex hormones 4. Masculinization 5. Increased 11 deoxycoticosterone 6. Hypertension
48
17 Alpha hydroxylase
1. Decreased cortisol 2. Decreased sex hormones 3. Increased mineralocoticoids 4. Hypertension 5. Hypokalemia 6. XY externally phenotypic female 7. No internal reproductive structures due to Mullerian inhibitory factor 8. XX externally phenotypic femal 9. Sexual infantilism
49
21 hydroxylase Deficiency
1. Decreased cortisol 2. Increased 17 hydroxyprogesterone 3. Decreased aldosterone 4. Hypotension 5. Increased renin 6. Hyperkalemia 7. Femal pseudohermaphroditism
50
Adenovirus
1. Non enveloped 2. linear 3. double stranded 4. Pharyngitis 5. Conjunctivitis 6. fever 7 summer swimming 8. daycare centers 9. acute hemorrhagic cystitis 10. pneumonia
51
Ataxia Telangiectasia
1. Defect in DNA repair 2. Cerebellar defects 3. Spider angiomas 4. senstivite to radiation 5. defective tumor suppressor gene 6. Increased risk of cancer, leukemias, and lymphomas 7. IgA deficiency 8. repeated sino pulmonary infections
52
Bruton's Agammaglobulinemia
1. X linked recessive 2. Defective tyrosine kinase 3. Blocks B cell maturation 4. Decreased immunoglobulins of all classes 5. Bacterial infections after 6 months 6. Maternal IgG protects before 6 months
53
Chondrosarcoma
1. Cartilaginous tumor 2. Malignant 3. Men 30-60 years old 4. Pelvic and femur bones 5. Glistening mass in medullary cavity 6. Can be primary in origin origin or from osteochondroma 7. Metastasize to lungs
54
Circle of Willis
1. Anterior cerebral arteries ACA supply motor/ sensory parts of cortex for lower extremities 2. Anterior Communicating artery Acomm connects ACA to ACA 3. Internal carotid arteries ICA 4. Middle cerebral arteries MCA supplies cortex for upper limbs and face 5. Posterior communicating artery Pcomm connects ICA to PCA 6. Posterior cerebral arteries PCA supplies occipital 7. Basilar Artery supplies Medulla, Pons and PCA
55
Common variable immunodeficiency
1. Defect in B cell maturation 2. Decreased Plasma cells 3. Decreased immunoglobulins 4. SInopulmonary infections 5. increased risk of autoimmune disease 6. Lymphoma
56
Craniopharyngioma
1. Hypopituitary 2. Remnants of rathkes pouch 3. Tooth enamel like calcification 4. Cholesterol crystals 5. Yellow viscous fluid 6. Headache 7. Bitemporal hemianopsia
57
Cytomegalovirus
1. Enveloped 2. double stranded DNA 3. Herpesvirus 5 4. Congenital TORCH infection 5. Mononucleosis 6. Non heterphile antibodies 7. AIDS retinitis and esophagitis 8. infection in transplant recipients 9. Owl's eye inclusions
58
Ependymoma
1. Occur in children 2. Fourth ventricle 3. Hydrocephalus 4. Perivascular pseudorosettes 5. Rod shaped blepharoplasts 6. Cauda equina in adults 7. poor prognosis
59
Epstein Barr Virus
1. Herpesvirus 4 2. Enveloped 3. Double stranded DNA 4. Linear 5. Virus attaches to CD21 in B cells 6. Infectious mononucleosis 7. Nasopharyngeal carcinoma 8. Burkitt's Lymphoma
60
Epstein Barr Virus Mononucleosis
1. Mononucleosis 2. Fever 3. Hepatosplenomegaly 4. Pharyngitis 5. Posterior cervical lymphadenopathy 6. Atypical lymphocytes 7. Heterophile antibodies 8. Rash develops if treated with ampicillin
61
Ewings Sarcoma
1. Most common in boys \<15 years old 2. 11;22 translocation 3. Long bones, pelvis, ribs 4. Diaphysis 5. Small Blue cells 6. Malignant 7. Aggressive 8. Onion skin appearance 9. Responsive to chemotherapy
62
Giant Cell Tumor
1. Osteoclastoma 2. Epiphyseal end of long bones 3. Peak incidence 20-40 years 4. Benign 5. Knee region 6. Soap bubble appearance on x ray 7. Spindle shaped cells 8. Multinucleated giant cells
63
Glioblastoma Multiforme
1. Most common primary brain tumor 2. Grade 4 astrocytoma 3. Can cross corpus callosum 4. Butterfly glioma 5. Pseudo-palisading tumor cells 6. Areas of necrosis and hemorrhage 7. Stain astrocytes for glial fibrillary acidic protein (GFAP) 8. Grave prognosis
64
HBV Characteristics
1. Hepadnavirus 2. Enveloped 3. Double stranded DNA 4. Partial circular 5. Has reverse transcriptase 6. IV drug use 7. Sex 8. Maternal fetal routes 9. 3 month incubation period
65
HBV Disease
1. Can turn chronic 2. Less than 10% of adults become chronic carriers 3. 90% of newborns become chronic carriers 4. Cirrhosis 5. Hepatocellular carcinoma 6. Membranous glomerulonephritis 7. Polyarteritis nodosa 8. Serum sickness like syndrome
66
Hemangioblastoma
1. Most often cerebellar 2. Associated with Von Hippel Lindau 3. Retinal Angiomas 4. Can produce EPO 5. Secondary polycythemia 6. Foamy cells 7. High vascularity
67
Herpes Simplex Virus
1. Enveloped 2. Double stranded DNA 3. Linear 4. Type 1 HSV 5. Gingivostomatitis 6. Keratoconjunctivitis 7. Encephalitis of temporal lobes 8. Latent in trigeminal ganglia 9. Type 2 HSV 10. Genital vesicles 11. Neonatal herpes 12. TORCHES 13. Latent in sacral ganglia 14. Tzank test 15. Multinucleated giant cells 16. Cowdry A inclusions 17. Acyclovir
68
Human Papillomavirus
1. Non enveloped 2. Circular 3. Double stranded DNA 4. Warts 1,2,6,11 5. Condyloma acuminata 6. Type 16, 18 7. Cervical carcinoma 8. Penile carcinoma 9. Immunosuppression/ AIDS 10. Worsened by smoking 11. Koilocytic change in squamous epithelium 12. Pyknotic nuclei surrounded by clear halo 13. Vaccine available
69
Hyper IgM Syndrome
1. Defective CD 40 Ligand on helper T cells 2. CD 40 ligand receptor on B cell 3. INability to class switch 4. Pyogenic abscess 5. Decreased IgG, IgA and IgE
70
Medulloblastoma
1. Occur in children 2. Cerebellum 3. Primitive neuroectodermal tumor PNET 4. Small blue cells 5. Lots of mitotic figures 6. Homer wright rosettes 7. Perivascular pseudorosettes 8. 4th Ventricle 9. Hydrocephalus 10. Ataxia 11. Wide based gait 12. Radiosensitive
71
Meningioma
1. Second most common adult primary brain tumor 2. Originate from arachnoid villi 3. Parasagittal 4. Contralateral leg weakness 5. Psammoma bodies 6. Calcifications 7. Increased bone density
72
Oligodendroglioma
1. Slow growing tumor 2. Frontal lobe 3. Chicken wire pattern 4. Fried egg appearance 5. Calcifications
73
Osteosarcoma
1. Osteogenic sarcoma 2. Peak incidence men 10-20 years old 3. Metaphysis of long bones 4. Knee region 5. Pagets disease 6. Radiation 7. Familial retinoblastoma 8. Codman triangle 9. Sunburst pattern from elevated periosteum 10. Grave prognosis
74
Parvovirus
1. Non enveloped 2. DNA 3. Single stranded 4. LIanear 5. Smallest DNA 6. B19 7. Erythema infectiosum 8. Slapped cheek rash in children 9. 5th disease 10. Arthritis in adults 11. Aplastic crisis in sickle cell 12. Hydrops fetalis 13. RBC aplasia
75
Pilocytic Astrocytoma
1. Most common in kids 2. Most common childhood brain tumor 3. Posterior fossa 4. Cerebellum 5. well circumscribed 6. GFAP 7. Rosenthal fibers 8. Eosinophilic corkscrew fibers
76
Pinealoma
1. Melatonin 2. Germinoma 3. Teratoma 4. Insomnia 5. Superior colliculi 6. Paralysis of upward gaze 7. Parinauds syndrome 8. Setting sun sign 9. Secrete B Hcg 10. Precocious puberty 11. Obstructs cerebral aqueduct 12. Hydrocephalus
77
Polyomavirus
1. Non enveloped 2. Double stranded DNA 3. Circular 4. BK virus 5. Kidney damages 6. JC virus 7. Progressive mulifocal leukoencephalopathy PML 8. HIV/ AIDS 9. Oligodendrocyte 10. Demylination of CNS
78
Pox Virus
1. Enveloped 2. Double stranded DNA 3. Linear 4. Non icosahedral 5. Smallpox 6. Cowpox 7. Mulluscum contagiosum 8. Umbilicated flesh colored domed lesions
79
Prolactinoma
1. Pituitary adenoma 2. Galactorrhea 3. Prolactin inhibits gonadotropin releasing hormone 4. Impotence 5. Amenorrhea 6. Bitemporal hemianopsia 7 treat with dopamine
80
Roseola
1. Exanthem 2. HHV 6 3. Enveloped 4. Double stranded DNA 5. Linear 6. High fevers can lead to seizures 7. Diffuse macular rash after fever
81
Schwannoma
1. 3rd most common adult brain tumor 2. Cerebellopontine angle 3. Cranial nerve VIII 4. Acoustic schwannoma 5. Tinnitus 6. Bilateral schwannoma in neurofibromatosis type 2 7. Cranial nerve V 8. Affects corneal reflex 9. S100 positive
82
Selective IgA Deficiency
1. Defect in class switching 2. Sinus and lung infections 3. Milk allergies 4. Diarrhea 5. Anaphylaxis on exposure to blood products with IgA 6. Cannot make IgA therefore make more IgE 7. Increase atopy
83
Sensitivity
1. Rules out 2. Screening test 3. TP / (FN + TP)
84
Severe Combined Immunodeficiency
1. Both B and T cell deficiency 2. Recurrent viral, bacterial, fungal, protozoal infections 3. Defective interleukin IL2 receptor 4. X linked 5. Adenosine deaminase deficiency 6. Failure to synthesize MHC II antigens 7. Treat with bone marrow transplant
85
Specificity
1. Rules in 2. Confirmatory test 3. TN / (TN + FP)
86
Varicella zoster
1. HHV3 2. Enveloped 3. double stranded DNA 4. Chicken pox 5. Pneumonia 6. Encephalitis 7. Trigeminal and dorsal root ganglia 8. Shingles 9. Tzanck test 10. Multinucleated giant cells 11. Cowdry A inclusion 12. Acyclovir
87
Wiskott Aldrich
1. Xlinked recessive defect 2. Progressive deletion of B and T cells 3. Thrombocytopenic purpura 4. Eczema 5. Infections 6. Decreased IgM 7. Increased IgE and IgA
88
1 Year milestone
1. Cruises 2. May take steps alone 3. Plays peek a boo 4. uses simple gestures like waving bye 5. says mama and dada 6. feeds self 7. birth weight triples 8. height increases 50 %
89
18 month milstones
1. Stacks 3 blocks 2. scribbles 3. walks backward 4. eats with a spoon 5. says 10 spontaneous words 6. tantrums
90
2 month milestones
1. Coos 2. Can hold head up but unsteady 3. Orients to voice 4. Social smile 5. Follows movements with eyes 6. Rooting reflex
91
2 year milestones
1. stacks 6 blocks 2. walks up and down stairs 1 step at a time 3. stands on tiptoes 4. throws overhead 5. jumps 6. run 7. 1/2 of speech is understandable to a stranger 8. follow a 2 step verbacl command 9. parallel play
92
3 years milestones
1. rides tricycle 2. climbs stairs with alternating feet 3. 9 block towers 4. begins toilet training 5. three word sentences 6. says first name 7. 3/4 of speech is understood 8. dresses and undresses self 9. copies circle
93
4 month milestones
1. follows object across midline 2. reach for objects with hands 3. holds a rattle 4. raise body on hands when on stomach 5. shows interest in image in mirror 6. rolls from stomach to back 7. babbles
94
4 years milestones
1. hop on one foot 2-3 times 2. stands on one foot for 2 seconds 3. counts to 10 4. draws simple stick figures 5. imaginary friends 6. buttons and zippers 7. grooms self 8. brushes teeth 9. uses scissors 10. birth height doubles 11. speech understood all of the time 12. copy square 13. catch bounced ball
95
6 months milestones
1. sit with support or tripod position 2. rolls over in both directions 3. raking grasp 4. transfer objects hand to hand 5. infant reflexes should be gone 6. babbles consonant sounds 7. development of object permanence 8. stranger anxiety
96
9 months milestone
1. pincer grasp 2. put things in mouth 3. further development of object permanence 4. uses finger to point at things 5. crawls 6. pulls to stand 7. understands no 8. responds to name 9. separation anxiety
97
acute gastritis
1. Erosive 2. disruption of mucosal barrier 3. caused by stress 4. alcohol 5. NSAIDS 6. uremia 7. burns 8. curlings ulcer 9. brain injury 10. cushings ulcer 11. increase H production
98
Adenosine deaminase deficiency
1. adenosine to inosine 2. excess ATP 3. inhibition of ribonucleotide reductase 4. Prevents DNA synthesis 5. Decreases B cells and T cells 6. major cause of SCID
99
Alkaptonuria
1. autosomal recessive 2. deficiency of homogentisic acid oxidase 3. in degradative pathway of tyrosine to fumarate 4. homogentisic acid harmful to cartilage 5. arthritis 6. dark connective tissue 7. urine turns black on standing
100
alpha 1 receptor
1. Gq subunit 2. increase vascular smooth muscle contraction 3. increase pupillary dilator muscle contraction 4. increase intestinal and bladder sphincter muscle contraction
101
alpha 2 receptor
1. Gi subunit 2. decrease sympathetic outflow 3. decrease insulin release 4. decrease lipolysis 5. increase platelet aggregation
102
Anterior cerebral artery
1. contralateral paralysis of lower limb 2. contralateral loss of sensation in lower limb
103
Beta 1 receptor
1. Gs protein class 2. increased heart rate 3. increased contractility 4. increased renin release 5. increased liplysis
104
Beta 2 receptor
1. Gs protein class 2. increased heart rate 3. increased contractility 4. increase lipolysis 5. increases insulin 6. increase aqeuous humor production 7. ciliary muscle relaxation 8. vasodilation 9. bronchodilation 10. uterine tone
105
Carcinoid syndrome
1. neuroendocrine cells 2. serotonin 3. appendix 4. chromogranin A 5. Neuron specific enolase stain 6. dense core bodies on EM 7. Symptoms when metastasize to liver 8. flushing 9. wheezing 10. right heart murmur 11. diarrhea
106
chronic gastritis
1. Type A 2. fundus and body 3. autoimmune disorder 4. autoantibodies to parietal cells 5. pernicious anemia 6. achlorhydria 7. type B 8. most common type 9. Helicobacter pylori 10. antrum 11. increase risk for MALT lymphoma 12. HIV/ AIDS 13. chrons disease
107
Classic galactosemia
1. autosomal recessive 2. absence of galactose 1 phosphate uridyltransferase 3. galactose 1 P to glucose 1 P 4. Accumulates in lens of the eye 5. infantile cataracts 6. failure to thrive 7. hepatomegaly 8. jaundice 9. mental retardation
108
Crohns disease characteristics
1. terminal ileum and colon 2. Rectal sparing 3. transmural inflammation 4. granulomas 5. skip lesions 6. cobblestone mucosa 7. fissures 8. fistulas 9. perianal disease 10. creeping fat 11. lymphoid aggregates 12. string sign on barium swallow
109
Crohns symptoms and associations
1. diarrhea 2. malabsorption 3. bile wasting 4. gallstones 5. oxalate kidney stones 6. ankylosing spondylitis 7. erythema nodosum 8. uveitis 9. migratory polyarthritis
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Cystinuria
1. defect of renal tubular amino acid transporter 2. cysteine 3. ornithine 4. lysine 5. argining 6. excess cystine in urine 7. staghorn kidney stones 8. cyanide nitroprusside test 9. acetazolamide to alkalinize the urine 10. hexagonal crystals
111
Essential fructosuria
1. autosomal recessive 2. defect in fructokinase 3. fructose to fructose 1 p 4. benign 5. fructose appears in blood and urine 6. fructose does not enter cell
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Fructose intolerance
1. deficiency of aldolase B 2. Fructose 1 p to DHAP or G3P 3. Accumulation of fructose 1p and phosphate trapping 4. inhibition of gluconeogensis 5 inhibition of glycogenolysis 6. hypoglycemia 7. vomiting 8. jaundice 9. cirrhosis 10. autosomal recessive
113
G6PD deficiency
1. hemolytic anemia 2. inflammatory response 3. fava beans 4. sulfonamides 5. primaquine 6. anti TB drugs 7. heinz bodies 8. bite cells 9. prevalent among blacks due to increase in malarial resistance
114
G6PD mechanism
1. turns NADP to NADPH 2. NADPH used by lutathione reductase 3. Detoxifies free radicals and peroxides 4. X linked recessive
115
Galactokinase deficiency
1. autosomal recessive 2. galactose to galactose 1P 3. galactose appears in blood and urine 4. benign 5. infantile cataractts 6. failure to develop a social smile
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Hartnup disease
1. autosomal recessive 2. defective transporter 3. neutral amino acids 4. on renal and intestinal cells 5. causes tryptophan excretion in urine 6. leads to pellagra 7. diarrhea 8. dermatitis 9. dementia
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hemochromatosis characteristics
1. hemosiderin deposition 2. autosomal recessive 3. HLA A3 4. secondary to transfusion therapy 5. increase iron 6. increase ferritin 7. decrease transferrin
118
Hemochromatosis
1. Micronodular cirrhosis 2. Hepatocellular carcinoma 3. Diabetes 4. Bronze skin coloring 5. Congestive heart failure 6. arthropathy 7. testicular atrophy 8. impotence
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Hirschsprung disease
1. Failure of neuronal crest cell migration 2. Involves rectum 3. Lack of auerbach and meissner plexus 4. Chronic constipation 5. failure to pass meconium 6. congenital megacolon 7. increased risk with down syndrome
120
Homocystinuria
1. 3 forms 2. All autosomal recessive 3. Methionine synthase 4. cystathionine synthase deficiency 5. Decreased affinity of cystathionine synthase for vit B6 6. Marfanoid body habitus 7. Kyphosis 8. Lens subluxation 9. Mental retardation 10. Atherosclerosis
121
Hyperammonenia
1. Hereditary urea cycle defects 2. Acquired through liver disease 3. inhibits the citric acid cycle 4. somnolence 5. slurring of speech 6. tremor 7. cerebral edema 8. vomiting 9. blurring of vision 10. limit protein in diet 11. lactulose 12. benzoate binds amino acid for excretion 13. phenylbutyrate
122
Lesch-nyhan syndrome
1. X linked recessive 2. Absence of HGPRT 3. Hypoxanthine to IMP 4. Guanine to GMP 5. Excess uric acid 6. Gout 7. retardation 8. self mutilation 9. choreoathetosis 10. PRPP is increased
123
Maple syrup urine disease
1. Defect in alpha ketoacid dehydrogenase 2. Blocked degradation of branched chain amino acids 3. Leucine 4. isoleucine 5. valine 6. seizures 7. mental retardation
124
Maternal phenylketonuria
1. Lack of proper diet during therapy like nutrasweet 2. congenital heart defects 3. Growth retardation 4. mental retardation 5. microcephaly
125
Meckels diverticulum
1. True diverticulum 2. vitelline duct 3. Yolk stalk 4. Contain ectopic tissue 5. pancreatic and gastic mucosa 6. hemorrhage 7. intussusceptions 8. volvulus 9. 2 feet from ileocecal valve 10. 2 inches long 11. 2% population 12. first 2 years of life 13. pertechnetate T99
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Middle cerebral artery
1. Contralateral paralysis upper limb and face 2. Contralateral loss of sensation of upper limb and face 3. Affects Wernicke's area and Broca's area 4. Aphasia if lesion in dominant (left) hemisphere 5. Hemineglect if lesion in nondominant (right) hemisphere
127
Ornithine Transcarbamylase deficiency
1. Most common urea cycle disorder 2. X linked recessive 3. Hyperammonemia 4. Decreased BUN 5. Carbamoyl phosphate is converted to orotic acid 6. Pyrimidine synthesis pathway 7. Evident in babies
128
Orotic aciduria
1. Autosomal recessive 2. Defect in orotic acid phosphoribosyl transferase 3. Or orotidine 5' phosphate decarboxylase 4. in de novo pyrimidine synthesis pathway 5. enzyme converts orotic acid to UMP 6. Increased orotic acid in urine 7. megaloblastic anemia 8. failure to thrive 9. no hyperammonemia 10. treatment oral uridine adminstration
129
Phenylketonuria
1. Decreased phenylalanine hydroxylase 2. Decreased tetrahydrobiopterin cofactor 3. Tyrosine becomes essential 4. mental retardation 5. Growth retardation 6. seizures 7. hypopigmentation 8. Eczema 9. musty or mousy body odor 10. Phenylalanine found in nutrasweet
130
Pyruvate dehydrogensase deficiency
1. Acquired from thiamine deficiency 2. Backup of alanine and pyruvate 3. Neurologic defects 4. Lactic acidosis 5. Treatment= ketogenic nutrients 6. Lysine and leucine (ketogenic nutrients)
131
Stomach Cancer
1. Almost always adenocarcinoma 2. Smoked foods containing nitrosamines 3. Achlorhydria 4. Helicobacter pylori 5. Type A blood 6. Signet ring cells 7. Linitis plastica (leather bottle stomach) 8. Acanthosis nigricans 9. Left supraclavicular lymph nodes 10. Virchows node 11. Subcutaneous periumbilical mets 12. Sister mary josephs nodule 13. Bilateral mets to ovaries 14. Krukenbergs tumor
132
Ulcerative colitis association
1. Toxic megacolon 2. Colorectal carcinoma 3. Anterior uveitis 4. Pyoderma gangrenosum 5. Primary sclerosing cholangitis
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Ulcerative colitis characteristics
1. Autoimmune 2. Mucosal and submucosal only 3. rectal involvement 4. stepwise lesions 5. Friable pseudopolyp 6. Crypt abscess 7. Loss of haustra 8. lead pipe appearance 9. Bloody diarrhea
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Wilson pathophysiology
1. Autosomal recessive 2. mutation in ATP7B gene 3. Chromosome 13 4. Decrease in ceruloplasmin 5. inadequate copper excretion 6. liver 7. brain 8. kidney 9. cornea 10. joints 11. Treat with penicillamine
135
Wilson Sypmtoms
1. Cirrhosis 2. Hepatocellular carcinoma 3. Basal ganglia degeneration 4. Dementia 5. Dyskinesia 6. Asterixis 7. Kayser Fleischer rings 8. Slit lamp diagnosis 9. Hemolytic anemia
136
Bacteroides fragilis
1. Gram negative 2. anaerobe 3. Produces vitamin K 4. Gastrointestinal abscess 5. Produces gas in tissue 6. foul smelling 7. Clindamycin 8. metronidazole
137
Bartonella Henselae
1. gram negative 2. pleomorphic 3. bacilli 4. cat scratch fever 5. lymphadenopathy 6. bacillary angiomatosis 7. aids patients 8. mimic kaposi's sarcoma 9. benign
138
Bordetella pertussis
1. gram negative 2. coccobacillus 3. bordet gengou agar 4. ADP ribosylating AB toxin 5. inhibits Gi to cause increase in cAMP 6. Lymphocytosis 7. Increase in insulin 8. Catarrhal phase is infectious period 9. Paroxysmal phase is symptomatic period 10. Whooping cough 11. Erythromycin
139
Borrelia burgdorferi
1. Lyme disease 2. Spirochete 3. Dark field microscopy 4. giemsa stain 5. silver stain 6. deer 7. Ixodes tick 8. Babesia 9. Ehrlichiosis 10. Flu like symptoms 11. Bulls eye rash 12. Erythema migrans 13. Bilateral bells palsy 14. Conduction defects 15. Arthropathy 16. Doxycycline 17. Ceftriaxone
140
Brucella
1. Gram negative 2. Coccobacilli 3. Unpasteurized milk 4. Goat cheese 5. Inside macrophages 6. Lymphadenopathy 7. Granulomas 8. Undulating fever 9. Doxycycline 10. Gentamicin
141
Campylobacter jejuni
1. gram negative 2. bacilli 3. flagella 4. curved 5. corkscrew appearance 6. oxidase positive 7. grows well at 42 degress 8. Undercooked poultry 9. unpasteurized milk 10. puppies with diarrhea 11. bloody diarrhea 12. Guillian-barre syndrome (ascending paralysis) 13. Reiter's syndrome or reactive arthritis
142
Chlamydia Characteristics
1. cannot make ATP 2. cell wall lacks muramic acid 3. giemsa stain 4. elementary body infects 5. intraepithelial 6. reticulate body replicates 7 inclusion bodies 8. doxycycline 9. azithromycin
143
Chlamydia tachomatis
1. A to C 2. Trachoma 3. Follicular conjunctivitis 4. causes blindness 5. Africa 6. L1 to 3 7. Lymphogranuloma venereum 8. buboes 9. genital ulcer 10. D to K 11. Urethritis and PID 12. Neonatal pneumonia 13. Staccato cough 14. Neonatal conjunctivitis
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Cori's disease
1. Type III glycogen storage disease 2. Debranching enzyme 3. Alpha 1,6 glucosidase 4. normal blood lactic acid levels 5. hepatomegaly 6. stunted growth 7. hypoglycemia
145
Coxiella burnetti
1. rickettsia 2. no arthropod vector 3. no rash 4. negative weil felix 5. cattle placenta 6. Q fever 7. Pneumonia 8 Flu like symptoms
146
E. coli
1. gram negative 2. bacilli 3. purple colony with metallic green sheen 4. lactose fermenting 5. pink on macconkey agar 6. diarrhea 7. lipid A septic shock 8. P pili pyelonephritis and cystitis 9. K capsule neonatal meningitis 10. k capsule pneumonia 11. H antigen flagella
147
EHEC
1. hamburger meat 2. O157:H7 3. Produces shiga like toxin 4. Inactivates 60s ribosome 5. bloody diarrhea 6. hemolytic uremic syndrome 7. hemolytic anemia 8. acute renal failure 9. thrombocytopenia 10. lysogeny 11. non sorbitol fermenting
148
Francisella Tularensis
1. gram negative 2. bacilli 3. fever 4. lymphadenopathy 5. deer fly 6. dermacentor wood tick 7. rabbit skinning
149
Gardnerella vaginalis
1. bacterial vaginosis 2. not an STD 3. Fishy smell 4. Whiff test 5. Grey vaginal discharge 6. Increase pH 7. Clue cells 8. squamous epithelial cells covered with bacteria 9. Mobiluncus coinfection 10. Metronidazole
150
Haemophilus ducreyi
1. gram negative bacteria 2. coccobacilli 3. pleomorphic 4. parallel short chains 5. School of fish appearance on gram stain 6. chancroid 7. painful genital ulcer 8. buboes 9. azithromycin 10 ceftriaxone
151
Haemophilus influenzae characteristics
1. gram negative 2. coccobacilli 3. PRP capsule in type B 4. Quellung 5. IgA protease 6. Chocolate agar 7. Factor V is NAD 8. Factor X is hematin 9. Staph aureus provides factor V
152
Haemophilus influenzae disease
1. pneumonia 2. meningitis 3. otitis media 4. cherry red epiglottitis 5. thumb print sight 6. COPD exacerbation 7. Ceftriaxone 8. Rifampin
153
Helicobactor pylori
1. gram negative 2. bacilli 3. Curved 4. polar flagellum 5. gastric and duodenal ulcers 6. ammonia 7. alkaline 8. gastic adenocarcinoma 9. MALT lymphoma 10. serology IgG antibody 11. stool antigen 12. Urease positive breath test 13. biopsy 14. 2 ABX and PPI
154
Klebsiella Characteristics
1. Gram negative 2. bacilli 3. intestinal flora 4. polysaccharide capsule 5. antiphagocytic virulence factor 6. positive quellung reaction 7. oxidase negative 8. fast lactose fermenter 9. Macconkey agar pink 10. mucoid colonies
155
Klebsiella disease
1. Aspiration pneumonia 2. alcoholics 3. diabetics 4. red currant jelly sputum 5. lung abscess 6. nosocomial UTI
156
Legionella Characteristics
1. Bacilli 2. Poor gram stain 3. charcoal yeast with rion and cysteine 4. Silver stain 5. Water sources 6. smokers and heavy drinkers 7. Detect antigen in urine
157
Legionella symptoms
1. high fever 2. diarrhea 3. increase liver enzyme 4. hyponatremia 5. tupe IV renal tubular acidosis 6. severe atypical pneumonia 7. pontiac fever 8. Fluoroquinolones 9. Macrolides
158
McArdles Disease
1. Type V glycogen storage disease 2. Muscle glycogen phosphorylase 3. increased glycogen in muscle 4. painful muscle cramps 5. myoglobinuria 6. normal lactic acid
159
mycoplasma pneumoniae
1. no cell wall and no gram stain 2. Cholesterol membrane 3. Eatons agar 4. fried egg colonies 5. atypical pneumonia 6. military recruits 7. Cold IgM autoimmune hemolytic anemia 8. Erythema multiforme 9. Tetracycline 10. Erythromycin
160
Neisseria gonorrhea characteristics
1. Gram negative 2. diplococci 3. chocolate agar 4. thayer martin media 5. VPN 6. Oxidase positive 7. Glucose fermenting 8. Pilus 9. Opa surface protein 10. rapid antigenic variation 11. IgA protease
161
Neisseria gonorrhea symptoms
1. Dysuria 2. Pelvic inflammatory disease 3. Fitz hugh Curtis syndrome 4. Neonatal conjunctivitis 5. Pharyngitis 6. Septic arthritis 7. tenosynovitis 8. Pustules on hands and feet 9. Susceptible when C 6-9 complement def 10. Ceftriaxone 11. Doxycycline 12. Azithromycin
162
Neisseria meningitidis
1. gram negative 2. diplococci 3. chocolate agar 4. Thayer martin media 5. VPN 6. Oxidase postive 7. Glucose fermenting 8. Maltose fermentation 9. Endotoxin 10. Polysaccharide capsule 11. antiphagocytic 12. IgA protease 13. Waterhouse friderichsen syndrome 14. Adrenal insufficiency 15. Petechial rash 16. Ceftriaxone 17. Rifampin prophylaxis
163
Pompe
1. Type II glycogen storage disease 2. Lysosomal alpha 1,4 glucosidase 3. Acid maltase 4. Heptaomegaly 5. Cardiomegaly 6. hyptonic 7. normal blood glucose
164
Pseudomonas Characteristics
1. Gram negative 2. Bacilli 3. Aerobic 4. Pyocyanin pigment 5. Blue green pigment 6. Grape like odor 7. Non lactose fermenting 8. Oxidase positive 9. catalase positive 10. Polysaccharide capsule 11. Endotoxin 12. exotoxin A 13. Inactivates elongation factor 2 14. Water source
165
Pseudomonas symptoms
1. Pneumonia 2. Cystic fibrosis 3. burn wounds 4. hot tub folliculitis 5. urinary tract infection 6. osteomyelitis associated with IV drug use 7. Puncture wound through shoes osteomyelitis 8. Diabetic osteomyelitis 9. COrneal infections in contact lens users 10. Endocarditis 11. Ecthyma gangrenosum
166
Rickettsia
1. Need CoA and NAD 2. Rocky Mountain spotted fever 3. Typhus 4. Ehrlichiosis 5. Q fever atypical 6. Arthropod vector 7. Fever 8. Headache 9. Rash 10. Weil felix reaction 11. treatment doxycycline
167
Rocky Mountain Spotted Fever
1. Rickettsia rickettsii 2. Dermacentor wood tick 3. Endemic to east coast 4. Fever 5. Headache 6. Rash starts on wrist and ankle 7. migrates towards trunk 8. Thrombocytopenia 9. Hyponatremia 10. Elevated liver enzymes
168
Salmonella enteritidis
1. Flagella 2. Gram negative 3. Bacilli 4. Oxidase negative 5. non lactose fermenting 6. MacConkey agar white 7. Hydrogen sulfide producing 8. animal reservoir chicken and turtles 9. Bloody diarrhea 10. Produces monocytic response 11. Do not give antibiotic 12. Osteomyelitis in sickle cell patient
169
Salmonella typhi
1. Typhoid fever 2. Peyers patches 3. Rose spots on abdomen 4. stored in gall bladder 5. osteomyelitis in sickle cell patients
170
Shigella
1. Gram negative 2. bacilli 3. non lactose fermenting 4. white on mac conkey agar 5. oxidase negative 6. Non h2s producing 7. Day care centers 8. High virulence 9. Replicates intracellularly 10 actin rocket 11. bloody diarrhea 12. shiga toxin 13. inhibits 60s ribosome 14. hemolytic uremic syndrome 15. hemolytic anemia 16. thrombocytopenia 17. kidney failure
171
Syphilis
1. treponema pallidum 2. Spirochete with characteristic motility 3. painless chancre 4. condylomata lata 5. generalized lymphadenopathy 6. rash on palms and soles 7. aortitis 8. gummas 9. Neurosyphilis 10. argyll robertson pupils 11. vasa vasorum 12. tabes dorsalis 13. penicillin 14. Jarisch herxheimer
172
Vibrio Cholera characteristics
1. Gram negative 2. Bacilli 3. Glucose fermenting 4. Non lactose fermenting 5. Oxidase positive 6. Comma shaped 7. Thrives in alkaline environment 8. From crustaceans
173
Vibrio cholera disease
1. ADP ribosylating AB toxin 2. Turn Gs on causing increase in cAMP 3. Secretion of Cl 4. Blocks reabsorption of Na 5. Rice water diarrhea
174
Von gierkes disease
1. Type 1 glycogen storage disease 2. Glucose 6 phosphatase 3. Severe hypoglycemia 4. Increased glycogen in liver 5. Increased blood lactic acid 6. hepatomegaly 7. Enlarged kidneys
175
Yersinia enterocolitica
1. Gram negative 2. Bacilli 3. Pork 4. Raw milk 5. Pet feces 6. day care centers 7. bloody diarrhea 8. Mesenteric adenitis 9. Granulomatous microabscess in mesenteric lymph nodes 10. mimic appendicitis 11. reiter's syndrome / reactive arthritis
176
Yersinia Pestis
1. Gram negative 2. Coccobacilli 3. Prairie dogs 4. Southwest region 5. Fleas 6. Polysaccharide capsule 7. F1 antigen 8. VW antigen 9. Inhibits macrophages 10. lymphadenopathy 11. Buboes 12. pneumonia 13. Black cutaneous hemorrhagic lesions
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