Shit list Flashcards Preview

Jenna's Shit List > Shit list > Flashcards

Flashcards in Shit list Deck (213):
1

Karyorrhexis

DNA laddering, endonucleases cleave every 180bp in internucleosomal regions. Indicates apoptosis 222

2

Apaf-1

Induces apoptosis; inhibited by Bcl-2 [overexpression of Bcl-2 prevents apoptosis = follicular lymphoma (t;14:18)222

3

CD95

 = Fas-R (on T-cells for negative selection)222

4

Liquefactive necrosis

Lysosomal enzymes; brain, abscess, pancreas.223

5

Casceous

Coagulative + liquefactive223

6

Fat necrosis

Lipase; fat cells lose nucleus 223

7

Fibrinoid necrosis

Immune (vasculitis), malignant HTN, pre-exlampsia 223

8

Cells of acute inflammation

Neurophils, eosinophils, antibodies Outcome = recover, abscess, chronic inflammation 225

9

Cells of chronic inflammation

Mononuclear (macrophages and lymphocytes), fibroblasts. Associated with BV formation, fibrosis, granulomas.  Outcome = scarring or amyloidosis225

10

Granulomas

Th1 --> IFN-g --> Macro --> TNF-a --> form and maintain granuloma 230

11

Dystrophic calcification

Abscess, fat necrosis, infarcts, thrombi, schistosomiasis, Monkenberg, congenital CMV and toxo (TORCH  - cerebral calcifications), psammoma bodies. In abnormal (diseased) tissues226

12

Metastatic calcification

MC in kidney, lung, and gastric mucosa; because increase pH.  In normal (healthy) tissues226

13

Leukocyte extravasation

   227

14

Wound healing mediators

TGF-a  -  Epithelial and fibroblast GF; induce and maintain granulomas229

15

Causes of Granulomas

 230

16

ESR

Increased: Pregnancy Decreased: HF and hypofibrinogenemia 230

17

Dialysis-related amyloidosis

B2 microglobulin; can present as carpal tunnel 231

18

Amyloidosis

AA = any inflammatory diseases (also FMF) Organ-spec: also meduallry CA thyroid cia calcitonin; AP via prolactin; Atria via ANP231

19

Desmoplasia

Fibrous233

20

K:L

3:1233

21

Hamartoma

Disorganized tissue in correct place234

22

Choristoma

Normal tissue in foreign place234

23

SM tumours

Benign = leiomyoma Malignant = leiomyosarcoma 234

24

Cachexia

IL-1, IL-6, TNF-a, IFN-g234

25

235-238

 235-238

26

235-238

DO THEM AGAIN235-238

27

Psammoma

PSMM: Papillary thyroid Serous cystadenoma Mesothelioma Meningioma239

28

Carcinomas traveling hematogenously

Renal cell CA HCC Follicular thyroid ChorioCA234

29

Lineweaver-Burk

 242

30

Lipoteichoic acid

Gram + Induces TNF-a and IL-1118

31

Outer membrane

Gram - Site of LPS: Lipid A induces TNF-a and IL-1; O = Ag118

32

Periplasm

Site of beta-lactamases118

33

Capsule

Used for vaccines Polysaccharide (except bacillus anthracis = d-glutamate) K Ag (except salmonella = Vi; s.pyogenes = M)118

34

Bacterial taxonomy

 119

35

No cell wall

MycoPLASMA, ureaPLASMA Contain sterols119

36

Gram stain limitations

 120

37

Stains

 120

38

Special cultures

 121

39

Obligate IC

 122

40

Facultative IC

"Salamon Needs bruce, My Little France Legionaire Yersinia"122

41

Encapsulated Bacteria

 122

42

Urease +

 122

43

Catalase +

 122

44

Exotoxins

   124

45

Endotoxin

 125

46

Gram +

 127

47

Gram -

 135

48

Zoonotic Bacteria

 142

49

Virus trends

 157

50

DNA Viruses

 158

51

HSV-6

Roseola Infantum; 6th disease158

52

Parvo B19

Erythema infectiosum; 5th disease (slap cheek) 158

53

HPV warts

1, 2, 6, 11158

54

HPV cancer

16, 18, 31, 33158

55

EBV

Infects B-cells via CD-21 Downey cells = reactive CD8+ T-lymphocytes159

56

RNA viruses

 161

57

HIV

Env: • GP 120 = attachment to CD4+; crosses placenta (FP neonate) • GP41 = fusion and entry Gag: p24 = capsid protein Pol: RT, asp protease, integrase [no proofreading --> drift]   CCR5 = macrophages; early infection CXCR4 = T cells; late infection168

58

A. Influenza

EMOP Epiglottitis can be in immunized kids Vaccine conjugated to diptheria toxin or another protein136

59

Pseudomonas

PSEUDDOm Ecthyma gangrenosum DM, burns, hot tub, CF137

60

Toxo Rx

Pyrimethamine + sulfadiazine (or clindamycin if sulfa allergy)150

61

Systemic micoses

Histoplasma = filled macrophage - Mississipi + Ohio Blastomycosis = broad based - Ohio Coccioidiomycosis = spherule with endospores - Cali Paracocciodiodomycosis = captains wheel - Latin America145

62

Gonorrhea and Chlamydia Rx

Ghono: ceftriaxone (3rd gen cephalosporin)   Chlam: azithromycin or doxycyclin  

63

Anthrax

Has D-glutamate capsule = poly PEPTIDE132

64

Post-viral pneumonia

A. Pneumo, S. aureus, H. influenza  

65

Corynebacterium

Has intracellular pyrophosphate granules, stain blue and red Also + ELEK test130

66

Black eschar

Cutaneous anthrax or mucor sp. 

67

Neutropenia

Increased risk of Gram -ve infections135

68

A. Aeruginosa

Exotoxin A (EF-2) contributes to ecthyma gangrenosum Also pyocyanin (ROS), elastase, PL-C137

69

Mycoplasma

PM is single PL layer righ in cholesterol No cell wall144

70

A. Botulinum

Heat LABILE Adults: 3Ds = diplopia, dystonia, dysphagia131

71

Hemolytic anemia

Pyruvate kinase deficiency = chronic hemolysis G6PD Deficiency = episodic  

72

Legionella

Pneumonia (lobar and unilateral, severe) GI effects (watery diarrhea) CNS (confusion, HA) Increased in smokers/chronic lung disease High fever with relative bradycardia See PMNs but no bacteria (FI)137

73

IgA protease vs. Protein A

Protein A = s. aureus = bind Fc of IgG IgA Protease = SHiN = cleave IgA to allow binding to mucus membranes128+122

74

Rubella

Downward rash, post-auricular LAD TOGAvirus 

75

Salmonella and yersinia

Can proliferate in LNs 

76

A. Diff

Rx = metro (mild; systemic abs) or vanco (severe; static); recurrent or limited systemic = fidaxomycin 131

77

A. Perfringens

Alpha-toxin = lecithinase = Plase-C131

78

Mycoplasma

No cell wall, so must use ribosome inhibitors like macrolides or tetracyclins 

79

Parvo B19

Aplastic anemia in sickle, fifth disease (erythema infectiosum), hydrops fetalis Only ssDNA, non-enveloped 

80

Rabies

Bullet shaped Negri bodies Purkinje cells of cerebellum; hippocampal neurons Killed vaccine Binds Ach-R --> retrograde up Bat, raccoon, skunk Fever/malaise --> agitation, photophobia, hydrophobia , hypersalivation -->paralysis ascending and flaccid and coma --> death Spasms cause hydrophobia, aerophobia (fear of flying) and dysphagia 165

81

A. Aeruginosa

Hot tubs and burns! PSEUDDO = pneumonia, sepsis, externa, UTI, DM, drugs, Osteomyelitis Ecthyma Gangrenosum137

82

A. Viridans

Makes dextrans from glucose Binds to damaged valves, at fibrin-platelet aggregates on the damamged valve129

83

LVG

PainFUL Inguinal LAD (buboes) 

84

Mitochondrial DNA

Synthesize mitochondrial things only: oxphos proteins, rRNA, tRNA68

85

GAS

Impetigo --> PSGN Pharyngitis --> PSGN and RHD   PSGN = 1-5 weeks after RHD = 2-6 weeks after129

86

HiB Vaccine

Conjugated to diptheria Non-typable = no capsule --> mucosal infections136

87

ParvoB19

ERYTHEMA INFECTIOSUM/FIFTHS DISEASE Circumoral pallor (because cheeks are red) [scarlet fever has cp too) Replicated in BM because of high prediliction for RBC precursors 158

88

Enteroviruses

Picornaviruses PECH (of PERCH) + EV-D68 and EV-71 PECH = poliovirus, echovirus, coxsackievirus, HAV   Cause >90% of aseptic meningitis cases (viral meningitis) Other causes: mumps, arboviruses (161), HSV-2161

89

EF-2

Corynebacterium diptheriae Pseudomonas aeruginosa124

90

S. pyo and H. flu markers

Strep pyogenes = PRY + (pyrrolidonyl arilamidase) H. Influenza = PRP+ (capsular antigen used in vaccines; polyribosylribitol phosphate)129 + 136

91

ToRCHeS

Blueberry muffin = To R C Eyes = To R Ears = R C S175

92

Klebsiella granulomatosis

STI granuloma inguinale Donovan bodies138

93

A. Neoformans

ID via: • Musicarmine stain • India ink • Latex agglutination • Growth on Saborard's 147

94

A. Diff

Toxin A = enterotoxin = watery diarrhea Toxin B = cytotoxin = colonic epithelial cell necrosis and fibrin deposition (via actin depolymerization)   Detect TOXINs in STOOL via PCR131

95

Satellite phenomenon

H flu growing around s aureus on blood agarU963

96

Cat + coag - staph

S. Epidermidis = novobiocin sensitive S. Saprophiticus = novobiocin resistant 127

97

A. Diptheriae

Grey membrane with pharyngitis LAD (bull neck) Myocarditis Arrythmias 130

98

Rubella

Rash, fever, post-auricular/cervical LAD, POLYARTHRITIS/ARTHALGIAS163

99

Poliomaviruses

Class I, circular dsDNA   JC: causes PML BK: in transplant pts, Ms = kidneys, causes nephropathy or hemorrhagic cystitis 158

100

DGI

Disseminated Gonococcal Infection Triad: polyarthritis, tenosynovitis, skin nodules (dermatitis)   One of the MCC of septic arthritis in young sexually active people136

101

Gohno vs chalm arthiritis

ALSO seen post GI infections (salmonela, shigella, campylobacter, yersinia)144 + 432

102

PYR

Pyrrolidonyl arylamidase Strep Pyogenes Group D enterococci127

103

Superantigens

APC MHC-II -------beta-region of TCR on T-cell   Beta region = variable region, so many T-cell lineages activated --> massive IL-2   Macrophages release Il-1 (fever) and TNF-a (fever and hypotension)209

104

Endotoxins/LPS

Macrophages activated DIRECTLY by the LPS @ CD14/TLR4209

105

Ataxia Telangectasia

Kid with ataxia (cerebellar degen), occulocutaneous telangectasia, IgA deficiency (also IgE and IgG) so recurrent sinopulmonary infections.   Increased AFP215

106

HIV bindings

Macrophages = 168

107

Leukocyte

 227

108

A. Diptheriae

Stain granules with aniline dyes or methylene blue130

109

A. Aureus

Ferments mannitol127

110

Coag -ve staph

Epidermidis = novobiocin sensitive Saprophyticus = novobiocin resistant127

111

HLA

 201

112

ADCC

NK cell expresses CD16 ---- Fc of IgG If no inhibitory signal via MHC-I  binding, then ADCC initiated (perforin and granzymes)   CD56 = unique marker201

113

Somatic hypermutation

Read FA201

114

Treg

CD3,4,25 FOXP3 Make anti-infl. cytokines202

115

Fas

Fas-L on CD8 Fas-R on target cell202

116

T cell activation

T-cell CD28 -----B7 (APC)203

117

B cell activation

B-cell CD40 ------CD40L (CD4 T-cell)203

118

Fab/Fc

Fab = idiotype Fc = isotype204

119

C3b

Opsonization AND clearance of immune complexes   .: missing (C3 deficiency) = pyogenic sinus and URT infections (encapsulated organisms), and increased type III hypersensitivities (can't clear complexes)206

120

Superantigens

Causes massive cytokine release by Th cells?209

121

Endotoxins/LPS

Directly bind macrophages @TLR4/CD14 No Th involvement, just macrophage release209

122

Vaccines with HIV

MMR = only live-attenuated to HIV pt.210

123

Adenovirus 4 and 7 vaccine

Live NON-attenuated! Give orally, stimulate IgA in GIT, get killed by acid, make IgA to it on ALL mucosal sites 210

124

Component vaccines

HepB and HPV210

125

Blood reaction

Type I HST: • Allergic - antihist • Anaphylactic (IgA defic) - epi Type II HST • Febrile non-hemolytic - reaction to DONOR HLA antigens and WBCs • Acute hemolytic - intravascular = ABO; extravascular = foreign Ag on donor RBC212

126

Nitroblue tetrazolium dye

Fail to turn blue (stay yellow) = + for CGD215

127

Coagulase

i.e. s. aureus Activates prothrombin (--> thrombin --> activates fibrinogen --> fibrin --> clot --> holds shit there)128

128

Lecithinase

A. perfringens131

129

Tryptase

Mast cell component, specific, indicates anaphylaxis 

130

Downey cell

REACTIVE T-lymphocyte (CD8+) 

131

Neutrophil chemotaxis

IL-8 C5a Kallicrine LT B4 PAF227

132

Paracortex

T cells and dencritic cells 

133

CGD

Defect of NADPH oxidase See recurrent bacterial and funcgal (Cat +) infections Abscesses/granulomas215

134

Auto-reactive IgM

RHEUMATOID ARTHRITIS!!!!! 

135

ADCC

Eosinophils NK PMN Macrophages201

136

Candidiasis

Th: prevent superficial candida infections PMNs: prevent dissemination of candida (phagocytose)147

137

Macrophage marker

CD14 

138

Rifampin

Prophylaxis for meningococcal and h. flu B Actually treats TB and leprosy (tuberculoid)188

139

NADPH

Glutathione reductoin in RBCs, FATTY ACID SYNTHESIS , CHOLESTEROL SYNTHESIS, STEROID SYNTHESIS, P450 METABOLISM, RESPIRATORY BURST102

140

Differential cyanosis

Older child/adult: Cyanosis and clubbing of TOES Via long-term PDA (Eisenmenger)   Infancy: Coarctation of the aorta with a PDA289

141

MSUD

Leucine --> neurotoxic Isoleucine --> metabolite --> sugar smell 107

142

CMV esophagitis

Linear ulcers 

143

Amiodarone

Class III (with 1-4 features) Does NOT have a risk for torsades (like the other class IIIs and IAs)309

144

A. Anthracis

Trimeric toxin:   B-component: gets LF and EF into eukaryotic cells EF: activates AC (calmodulin-dependent) --> edema LF: ZINC-dependent, protease, inhibits MAPK signalling --> Apoptosis and dysfunction     Also D-glutamate capsule!132

145

SLE

SLE can casue pancytopenia via auto-Abs • RBCs = warm agglutinins; positive Coombs, sphereocytes, extravascular hemolysis • Platelets: like ITP • Neutropenia less common433

146

Cranial nerve paths

 475

147

Congenital long QT

Romano-Ward = AD, pure cardio Jervell and Lange-Nielsen = AR, sensorineural deafness283

148

Microtubule inhibitor side effects

Vincristine = neurotoxicity Vinblastine = bone marrow suppression411

149

PKU

Musty odor, posture/gait problems, eczema, intellectual disability, seizures, fair skinned, tremmors, hypopigmented basal ganglia   *probably from foreign country because we heel test at birth AR107

150

Bisphosphonates

"dronates" Ppi analong Make hydroxyapatite insoluble and interfere with Ocl activity For OP and Pagets and malignancy-induces hyper Ca AE: erosive esophagitis, jaw osteonecrosis, unchanged in urine445

151

Homocysteinuria

Intellectual disability, OP, marfanoid habitus, kyphosis, lens subluxation (down and in), thombosis (a and v), atherosclerosis108

152

Sarcoidosis s/s

Restrictive lung disease, lupus pernio, erythema nodosum, bells palsy, granulomas with schaumman and asteroid bodies, uveitis434

153

Polymyositis/dermatomyositis

Anti-Jo Anti-SRP Anti-Mi-2 CK   Poly: endomysial, CD8, symmetric proximal weakness mc = shoulders Dermato: perimysial, CD4, malar, grottons, helicotrope, shawl and face435

154

Scleroderma

Diffuse = scl-70 (topo I); renal, pulm, GIT, cardio Limited = anti-centromere; skin of face and hands + CREST436

155

Skin terms

 438

156

Cellulitis vs erysipelas

Cellulitis = deep dermis and subQ tissue Erysipelas = upper dermis and superficial lymphatics440

157

SSSS vs TEN

SJS 30%440

158

Erythema Multiforme

 441

159

Erythema Nodosum

 442

160

Acanthosis nigracans

Hyperinsulinemia OR visceral malignancies!442

161

Skin cancers

Basal cell: sun, UPPER lip, pallisading nuclei   Squamous cell: UBV, chronic inflammation, arsenic, immunosuppression; face, hands, LOWER lip, ears; to LN but rare mets • Actinic keratosis = scaly precursor • Keratoacanthoma = variant, grows 4-6 weeks, spontaneous regression   Melanoma: ABCDE, S-100, mets (depth = breslow = determining factor), BRAF V600E (Rx = vemurafenib = BRAF-Kinase inhibitor) • Superficial spreading • Nodular • Lentigo Malinga • Acral lentiginous ◦ Subungual (nail) = variant443

162

Ankylosing spondylitis

Sacroiliitis, anterior uveitis, aortic regurg, peripheral enthesitis, enthesitis of costovertrbral and costosternal joints --> hypoventilation, 1% apical pulmonary fibrosis432

163

Xeroderma pigmentosum

NER defect --> cant repair thymidine-dimers Dry skin with erythema, scaling, hypopigmented regions, and lentigos Later: skin atrophy, telangectasias, hypo and hyper pigmented areas443

164

ACL and PCL

ACL: • Connects from posterior femur to ANT TIBIA (medial side) • Prevents hyperflexion (anterior movement of tibia on femur)   PCL: • Connect from posterior femur to POST TIBIA (fibular side) • Prevents hyperextension (posterior movement of tibia on femur)416

165

OI

Problem with bone matrix formation 

166

Tongue muscles

XII • Hyoglossus = back and down • Genioglossus = out • Styloglossus = up (swallowing) X • Palatoglossus = lift posterior tongue for swallowing450

167

Bilateral acoustic neuromas

NF2451

168

Myelin origins

Oligodendrocytes = neuroectoderm Schwann = NCC452

169

Sensory receptors

 452

170

NTs

 453

171

Hypothalamus food

Increased lat increases fat 454

172

Circadian

Controls: NE, melatonin, ACTH, prolactin455

173

Drugs and sleep

Delta: alcohol, benz, barb     (so can decrease night terrors/sleepwalking) REM: alcohol, benzo, barb, NE455

174

Basal ganglia

Striatum = caudate + putamen Lentiform nucleus = putamen + globus pallidus   Lentiform = wilsons SNc = perkinsons Caudate = Huntingtons Internal capsule = lacunar infarct STN = hemiballismus Thalamus = thalamic/post-stroke syndrome 458

175

Dystonia vs myotonia

Dystonia = sustained contractions Myotonia = brief, suden contractions (liver or kidney failure; seizures)459

176

Parkinsons

A-synuclein --> lewy bodies MTPT459

177

Huntingtons

CAG chrom 4 Dememtia, choreoform, depression, aggression Caudate degeneration - NMDA-R binding and glutamate mediated Ex vacuo hydrocephalus of frontal horns459

178

Kluver bucy

Assoc. with HSV-1461

179

Asomatognosia

Ignore half of world Via nondominant parietal-temporal cortex lesion461

180

Gerstmann syndrome

Agraphia, acalculia, finger agnodia, left-right disorientation, alexia dominant parietal-temporal cortex lesion461

181

Hippocampus

Anterograde amnesia461

182

PPRF lesion

Eyes look AWAY461

183

Frontal eye field lesion

Eyes look TOWARDS461

184

Blood supply

Cingulate gyrus (limbic) = ACA Corpus callosum (interhemispheric connection) = MCA462

185

Brain Autoregulation

Relies mostly on CO2 Theraputic hyperventilation = decrease CO2 .: "inc. O2" .: brain vasocontriction .: decrease acute increases in ICP   Cerebral perfusion pressure (CPP) = MAP - ICP • If MAP decreases • If ICP increases • CAUSES decreased CPP --> brain death463

186

1 Week post-infarct

Microglia have moved in --> engulphing stuff --> filled with lipid from myelin467

187

Fragile X

2nd MCC mental retardation (FMR-1 gene) CGG repeats MVP85

188

Measles

Lymphadenitis with Wethin-Finkeldey giant cells = fused lymphocytes, in background of paracortical hyperplasia Has HA!164

189

Opsoclonus-myoclonus

NEUROblastoma N-myc Abdominal mass, irregular, can cross midline Homer-writte rosettes Bombesin and neuron-specific enolase +ve325

190

Uncal herniation

CN3 Ipsi or contra CSTr Ipsi PCA = contralateral hemianopsia with macular sparing 

191

Buspirone vs. Bupropion

Buspirone: • 5HT1A partial agonist • Rx for GAD • No sedation, addiction, tolerance, alcohol interactions, euphoria, hypnotic • JUST anxiolytic • Good for benzo abusing patients (decreased abuse potential) Bupropion: • Atypical antidepressant • Rx depression, smoking • No sexual dysfunction • JUST increases NE and DA via deceased reuptake • AE = amphetamine-like (tachycardia, insomnia), Ha, seizures (especially with history or annorexia/bulemia522 + 524

192

IMAGE

 U794

193

Lysosomal storage diseases

 111

194

Striatum

Caudate + putamen458

195

Central post-stroke pain syndrome

Neuropathic pain Via thalamic lesion Allodynia and dysthesia (abnormal sensations)465

196

Epidural and subdural areas

Epidural: CANNOT cross suture lines Subdural: CANNOT cross falx466

197

Intraparenchymal hemorrhage

Via: • HTN (MC) - BG + IC via bouchard microaneurisms • Amyloid angiopathy (lobar) • Vasculitis • Neplasm MC basal ganglia or internal capsule (but can be lobar)466

198

Hemorrhagic stroke

MC via HTN, antigoagulation, or cancer (abn. vessels bleed), reperfusion injury from vessel fragility467

199

Ischemic strokes

Thombotic  = MCA via AS plaque Embolic = multiple vascular territories via a fib or DVT with PFO Hypoxic = watershed via CV surgeries (hypoperfusion or hypoxemia)467

200

Pseudotumour cerebri

 468

201

Leg vs. arm location in spinal cord

DC: Leg medial CSTr: Arm medial ST: Arm medial469

202

Neurial and mysial inflammation

Neural: • Endoneurium = GBS • (perineurium = needs to be rejoined for surgery) Muscle: • Endomysium = polio AND polymyositis ◦ Anti-endomysium Abs in celiac disease • Perimysium = dermatomyositis   

203

Riluzole

Rx for ALS (glutamate antagonist)471

204

Polio

CSF: WBCs and some protein (NO glucose change) Virus from throat or stool472

205

Brown sequard above T1

Horners via oculocympathetic pathway lesion472

206

Dermatomes

L1 = inguinal ligament L4 = kneecaps L1-L2 = cremaster L3-L4 = winks galore472

207

Galant reflex

Stroke side causes lateral flexion to that side472

208

Colliculi

• Inferior = auditory 474

209

CN nucleus lesions

5 = jaw TOWARDS 10 = uvula AWAY (collapse) 11 = weak CONTRA 12 = tongue TOWARDS 476

210

Cavernous sinus syndrome

• Horners • Variable opthalmoplegia (CN 6 most at risk!) • Decreased corneal sensation • [maybe decreased maxillary sensation if V2 affected] •  
Via: • Pituitary tumour • Cavernous-carotid fistula • Cavernous sinus thrombosis via infection • Cavernous carotid aneurism 477

211

Basilar membrane

Base = thin = high frequencies Apex = wide = low frequencies477

212

Cholesteatoma

Overgrowth of desquamated keratin debris in MIDDLE EAR Can degrade ossicles 478

213

Bells palsy causes

• Idiopathic • Lyme • HSV-1 • HSV-3 (Ramsay-Hunt) • Tumour • DM • Sarcoidosis478