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Flashcards in Test 16 Deck (48):
1

Why do hepatitis C antibodies NOT confer effective immunity against the infection?

There's a large variety in hep C virus envelop proteins, so the host Abs always lag behind the production of new mutant strains of HCV making it REALLY hard to confer immunity.

2

A 34 y/o immigrant presents w/ patchy areas of skin anesthesia and hypopigmentation on his upper extremities. Nerve biopsy shows bacteria invading SCHWANN cells.

Myobacterium leprae

(grows best at temps slightly lower than body temp so it commonly effects extremities)

3

What limits tuberculoid leprosy?

Least severe form

Limited by intact cell mediated immune system

4

In what type of pts does lepromatous leprosy occur in?

pts w/ a weak cell mediated Th1 immune response--mphages are nevere given the signal to kill myobacterial organisms so it disseminates (lionized facies)

5

What spirochete is responsible for Lyme disease?

Borrelia burgdorferi

6

What spirochete is responsible for syphilis?

Treponema pallidum

7

Describe the progression of syphilis.

Painless chancre> diffuse eruption of erythematous macules (palms and soles) and formation of conyloma lata> gummas of skin and bone, aortitis, neurosyphilis

8

What gram - rod causes mild enteritis in immunocompetent pts and mild systemic bacteremic illness in immunocompromised pts?

Campylobacter fetus

9

A 64 yearl old man loses consciousness b/c of low bp while buttoning his tight collar shirt. What afferent nerves are responsible for this?

External pressure on the carotid sinus of the internal carotid area stimulates baroreceptors in the carotid sinus walls>
CN 9>
vasodilation, decrease in heart rate/contractility/decrease in bp

10

Where do fibers from both the carotid sinuses and aortic arch baroreceptors terminate?

Both CN 9 and CN 10 terminate on the solitary nucleus of the medulla

11

What lies immediately deep to the tip of the 12th rib on the left?

kidney

11/12th ribs are floating ribs--the distal tip fo the 12th rib can be displaced into the retroperitoneum when fractured and LACERATE the kidney

12

lies under the 9th, 10th, 11th ribs

spleen

13

lies under the 8, 9, 10, 11 rib

liver

14

fractures of 1st through 6th ribs may damage...

visceral pleura

15

What type of trauma causes pancreatic damage?

crushing abdominal damage

16

What method is used in designing case-control studies to control for confounding?

Matching: Selecting variables that could be confounders (age, race), so that there is a similar distribution

Cases (pt's w/ CRC) are matched w/ controls (neighbors) of similar age and race--also accounts for socioeconomic status/environmental factors

17

What is a confounding variable?

A factor related to BOTH the exposure and the outcome but NOT the casual pathway

18

Lactic acidosis
Raged red skeletal muscle fibers

Mitochondrial myopathy

19

Heteroplasmy

Coexistence of both mutated and WT versions of mitochondrial genomes in an individual cell> variable expression in a mitochondrial related disease

20

All invdividuals with a given gene express its phenotype

full penetrance

21

Presence of genetically distinct cell lines in the same individual

mosaicism

22

A pt has a mutation that affects G protein signaling and presents w/ unilateral cafe-au lait spots, polyostotic fibrous dysplasia, precocious puberty and multiple endocrine abnormalities.

McCune Albright Syndrome

23

Both members of a given pair of nuclear chromosomes are inherited from the same parent

Uniparental disomy

24

Bounding femoral pulses and carotid pulses accompanied by head bobbing

Water hammer pulses w/ each heart beat are signs of aortic regurgitation d/t LARGE LV stroke volume

25

What is the major determinant of the degree of R to L intracardiac shunting, and thus the severity of the hypoxemic sx, in pts with TOF?

RF outflow obstruction (pulmonary stenosis)

26

What characterizes TOF?

pulmonary stenosis
VSD
RVH
over riding aorta (straddles VSD)

27

What happens to PTH, calcitonin and vit D in resopnse to Ca loading?

PTH and Vit D decrease (increase in Ca NFB)

Calcitonin increases (sequester excess Ca)

28

Polycythemia Vera, essential thrombocytosis and primary myelofibrosis are all examples of..

Chronic myeloproliferative disorders

29

Mutation in V617F affecting JAK 2 (cytoplsmic TK) leading to constitutive TK activity> cytokine independent activation of STAT TF

Chronic MP disorders

30

Easy bruising, microangiopathic occlusion, THROMBOCYTOSIS (increased number of platelets) and megakaryocytic hyperplasia

Essential thrombocytosis

Over production of normal platelets> bleeding and thrombosis. Bone marrow contains enlarged megakaryocytes

31

Pruritis, splenomegaly, thrombotic complications, ERYTHROCYTOSIS (increased number of RBC) and thryobocytosis

POlycythemia Vera

Itching after hot shower (d/t increase in basophils).

32

Severe, burning pain and red blue coloration d/t episodic blood clots in vessels of extremities.

Polycyhtemia vera

33

Severe fatigue, MASSIVE splenomegaly (causing early satiety/abdominal discomfort, hepatomegaly, anemia and BONE MARROW FIRBORIS

primary myelofibrosis

Obliteration of bone marrow d/t increased fibroblast activity in response to proliferation of monoclonal cells lines.

Tear drop and nucleated RBC

34

What characterizes chronic MP disorders?

overproliferation of myeloid cells

35

Philadelphia chromosome t(9:22) mutation BCR-ABL fusion protein

Chronic mylogenous leukemia

36

Fatigue, weight loss, splenomegaly, LEUKOCYTOSIS W/ MARKED LEFT SHIFT (increased neutrophils, metamyelocytes, bsophils)

Chronic myelogoenous leukemia

37

Fever, fatigue, pallor, petechiae and bleeding in children.

Acute lymphocytic leukemia

38

T 15,17 leads to formation of fusion gene between PML and retinoic acid receptor alpha genes blocking differentiation of myeloid precursors.

Acute promyelocytic leukemia

(responds to all-trans retinoic acid--Vit A)

39

Lymphoproliferative disorder involving B lymphocytes and smudge cells on peripheral blood smear.

Chronic lymphocytic leukemia

>60

40

8,14 translocation
c-myc oncogene

Burkitt Lymphoma (non-hodgkin)

41

Microangiopathic hemolytic anemia (HUS), thrombocytopenia, and renal insufficiency after GI infection.

E. coli 0157:H7 in UNDERCOOKED GROUND BEEF causes HUS in children under

-shistocytes on blood smear, platelet consumption, decreased renal blood flow

42

Custard, mayonnaise, salted meats

s. aureus

preformed toxin> watery nonbloody diarrhea

43

Fried rice ingestion

Bacillus cereus

44

Raw oysters

vibrio parahaemolyticus (voluminous water diarrhea, like cholera)
vibrio vulnificus

45

Raw egg, raw chicken consumption and improper food handling

salmonella

46

Canned beans/jarred food

c. botulinum

47

Maxillary prominences fail to fuse w/ intermaxillary segment during early development

cleft lip

48

palatine shelves of maxillary prominence fail to fuse w/ one another or primary palate

cleft palate