Quiz 49 And 50 Flashcards

1
Q

What symptoms can be seen in a patient infected with entamoeba histolytica?

A

Patient with bloody diarrhea and liver tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the trophozoite of E. histolytica.

A

“Cart-wheel” distribution of chromatin in the nucleus; ingested RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does the third pharyngeal pouch give rise to?

A

Inferior parathyroids and thymus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What pouch are the superior parathyroids derived from?

A

Fourth pharyngeal pouch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the embryonic structure that gives rise to muscles of facial expression?

A

Second pharyngeal pouch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What artery can be involved in temporal (giant cell) arteritis, resulting in blindness?

A

Ophthalmic artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What microorganism is responsible for progressive multifocal leukoencephalopathy? What cells are affected?

A

JC virus (a polyomavirus) infects oligodendroglial cells; eosinophilic intranuclear inclusions represents JC virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What population is susceptible to PML?

A

Patients with AIDs; reactivation in immunosuppressed hosts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Multifocal lesions in the hemispheric or cerebellar white matter

A

PML

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What transmits borrelia burgdorferi?

A

Ixodes scapularis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What diseases might one see bone marrow expansion in the calvarium? Why?

A

Sickle cell anemia and thalassemia major; both diseases result in chronic anemia - requiring compensatory hematopoiesis in the flat bones of the skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

“Crew-cut” or “hair on end” appearance is seen on radiograph, what diseases should be on the differential?

A

Sickle cell anemia and thalassemia major

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is thalassemia major?

A

Homozygous Beta thalassemia; severely deficient or absent B-globin chain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the point mutation resulting in sickle cell anemia?

A

Valine for glutamate at the 6th position of the beta-globin chain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the MOA of lactulose in regards to inhibiting ammonia absorption?

A

Lactulose is broken down but colonic bacteria; breakdown products acidify the colon, favoring protonation of NH3 to form NH4+; the positive charge prevents it from diffusing across into the blood stream and is therefore excreted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the MOA of the toxin produced by Enterotoxigenic E. coli?

A

Activate adenylate or guanylate cyclase, resulting in overproduction of cAMP, leading to diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What E. coli commonly infects travelers?

A

ETEC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What strain of E. coli is associated with consuming undercooked hamburger?

A

EHEC; has shiga like toxin that produces bloody diarrhea and HUS; associated with strain O157;H7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the characteristic findings of blood counts and peripheral smears in hairy cell leukemia?

A

Pancytopenia; hairy cells are seen - positive for tartrate-resistant acid phosphatase (TRAP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When are smudge cells seen?

A

Chronic lymphocytic leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What cell surface markers are found to be positive in hairy cell leukemia?

A

CD19, CD20, CD25 & CD11c (monocyte-associated antigens) and Surface IgG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the treatment for hairy cell leukemia?

A

2-chlorodeoxyadenosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What organism gives rise to abdominal rash known as “rose spots”

A

Salmonella enterica subspecies typhi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What type of climate is Yersinia enterocolitica usually associated with? Why?

A

Colder climates - organism can be grown well at 4 degrees celcius.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What organism causes pseudoappendicitis? What age group?

A

Yersinia enterocolitica; older children/young adults

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does yersinia enterocolitica present in very young children?

A

Febrile, bloody, pussy diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Clavicles are formed via what type of fetal bone formation?

A

Intramembranous ossification

28
Q

What type of inheritance pattern is seen in G6PD?

A

X-linked recessive

29
Q

What drugs can cause oxidative distress to RBCs in a patient with G6PD?

A

Dapsone, primaquine (antimalarial) and sulfonamides

30
Q

What part of the colon is usually affected by diverticulitis?

A

Distal (left) colon; but in severe cases can extend up to the cecum (mimics acute appendicitis)

31
Q

What is the inheritance pattern of Fragile X syndrome?

A

X-linked; trinucleotide repeat expansion CGG

32
Q

What cardiac disorders are seen in Fragile X syndrome?

A

Mitral valve prolapse and aortic root dilatation

33
Q

ring-enhancing lesion seen on CT in a child with headache and fever

A

Brain abscess

34
Q

Ring enhancing lesion on CT in a patient with HIV

A

Toxoplasmosis; esp with CD4 count <100

35
Q

What is the most common cause of bacterial brain abscess in children?

A

Recurrent otitis media

36
Q

What are the most common pathogens of otitis media?

A

S. Pneumonia, H. Influenza, moraxella catarrhalis

37
Q

What regions of the brain are most affected by complications from middle-ear infections?

A

Cerebellar and temporal lobes

38
Q

What rash can be seen in secondary syphilis?

A

Rash on palms and soles

39
Q

What is the causative organism of syphilis?

A

T. Pallidum

40
Q

What is the morphology of T. Pallidum?

A

Spirochete; a thin spirillar prokaryote that is motile (via internal flagellum)

41
Q

What results from an injury to the lower trunk of the brachial plexus?

A

Clawing of all digits;

42
Q

What structures are affected in thoracic outlet syndrome?

A

Lower trunk of the brachial plexus and subclavian artery

43
Q

Why can one see total claw hand in a lower trunk brachial plexus injury?

A

Loss of lumbrical function/innervation

44
Q

What is a first line treatment in diabetic gastroparesis?

A

Prokinetic agents

45
Q

What is the MOA of metoclopramide?

A

Dopamine receptor blocker

46
Q

What type of medications can give rise to pseudoparkinsonism?

A

Dopamine antagonists

47
Q

What is Monckeber arteriosclerosis? What symptoms result?

A

Medial calcific sclerosis (calcifications in the media of small-medium arteries); no symptoms result as lumen diameter does not change

48
Q

What labs can aid in the diagnosis of carcinoid syndrome?

A

Elevated serum chromogranin A and 5 hydroxyindoleacetic acid (5HIAA)

49
Q

What cardiac affects can result from carcinoid syndrome?

A

Right sided heart failure secondary to tricuspid valve stenosis and endocardial fibrosis caused by serotonin’s action

Cells in the lung can break down serotonin

50
Q

What is the MOA of octreotide in regards to carcinoid tumors?

A

Synthetic somatostatin analog that binds to receptors on the carcinoid tumor

51
Q

What antibiotic can result in grey baby syndrome?

A

Chloramphenicol

52
Q

What is the MOA of chloramphenicol?

A

Inhibits ribosomal peptidyl transferase.

53
Q

What drug class is used in treatment of BPH?

A

Alpha-1 antagonists

54
Q

What infection causes thickening of the meninges?

A

Tertiary syphilis

55
Q

What region of the brain is exquisitely sensitive to hypoxic damage?

A

Hippocampus

56
Q

What region of the brain is important in developing new information?

A

Hippocampus

57
Q

Damage to the hippocampus produces what deficit?

A

Inability to form new memories (anterograde amnesia)

58
Q

What is SVC syndrome? When does one see it?

A

SVC syndrome is characterized by obstruction of the venous return resulting in facial and arm edema, JVD. Over 85% of cases are related to malignancy (SCC or squamous cell carcinoma)

59
Q

What is the MOA of clarithromycin?

A

Binds to 50S ribosomal subunit; blocks protein synthesis

60
Q

What are the affects of macrolides on the CYP system?

A

Inhibit CYP3A4

61
Q

What is the affect of rifampin on the CYP system?

A

Potent hepatic enzyme induce

62
Q

Describe the defense mechanism of splitting.

A

Objects or people are either “all bad” or “all good”; the world is pictured in extreme terms

63
Q

What results due to Rh incompatibility?

A

Erythroblastosis fetalis

64
Q

What are the consequences of erythroblastosis fetalis?

A

Anemia with high output HF, edema, and elevated unconjugated bilirubin

65
Q

In erythroblastosis fetalis, the high serum bilirubin can result in damage to what?

A

CNS - esp the basal ganglia; process known as kernicterus