Flashcards in test #16 4.4 Deck (156)
why does infxn w/ neisseria gonorrhoeae not result in lasting immunity?
modify outer membrane proteins by antigenic variation. Abs made in infxn -- specific for single specific antigenic epitope.
vasculitis of medium-sized arteries
most serious complication of kawasaki disease?
coronary artery aneurysm.
symptoms of kawasaki
(1) persistent FEVER (2) bilateral CONJUNCTIVITIS (3) LYMPHADENOPATHY (4) CUTANEOUS involvement: (a) oropharyngeal: erythema of palatine mucosa, fissured erythematous lips, "strawberry" tongue (b) peripheral extremities: edema of hands * feet, erythema of palms and soles, desquamation of fingertips (periungual). (c) generalized rash: polymorphous (usu urticarial) erythemtaous rash beginning on extremities and moving to trunk (centripetal speed).
serious complication: coronary artery aneursym
which vasculitides are associated w/ mononeuritis multiplex (peripheral neuropathy of multiple individual nerves)
(1) granulomatosis w/ polyangiitis (2) polyarteritis nodosa
caudal regression syndrome. associated w/ & (3) signs
uncontrolled maternal diabetes. babies w/ agenesis of sacrum & occasionally lumbar spine --> (1) flaccid paralysis of legs, (2) dorsiflexed contractures of feet, (3) urinary incontenience
range of caudal regression syndrome
isolated anal atresia to sirenomelia (mermaid syndrome)
mermaid syndrome, can result from caudal regression syndrome. legs fused together
cocaine on pregnancy
vasoconstriction: insufficient blood flow to developing fetus --> spontaneous abortion, intrauterine growth retardation, placental abruption, and/or prematurity
an URI that can negatively impact baby (gestation)
rubella (TORCHES). transmitted respiratroy. MR and congenital heart defects.
vitamin A overdose in pregnancy results in...
craniofacial abnormalities, posterior fossa CNS, auditory defects, abnormalities of great vessels (similar to DiGeorge)
vitamin A overdose in pregnancy in baby mimics?
strict vegetarians (esp vegans) are at risk for which nutritional defeciencies?
(1) iron and (2) B12
(1) very weak opiod agonist; also inhibits 5-HT and NE reuptake (2) (SNRI). mult ntx: tram it all w/ tramadol. use for chronic pain
positive predictive value
of those two test positive, how many are true positives.
validity of a test measured by
specificity and sensitivity
95% of gas gangrene caused by.. how?
Clostridium perfringes. toxin: phospholipase, cell death --> tissue damage, necrosis, reduction of blood supply. organism metabolizes carbohydrates --> generate gas.
clostridium perfinges causes (2)
(1) gas gangrene w/ penetration (2) transient watery diarrhea LATE-onset food poisoning, ingestion of spores in reheated meat dishes. late bc spores must germinate
early onset food poisoning (2) vs. late onset (1)
early-onset: preformed toxin (1) s. aureus (2) b. cereus.
late onset: c. perfringes (must germinate)
(2) bacteria associated w/ polyarthritis
(1) septic arthritis: gonorrhea (2) Group A strep
culture agar for cornybacterium diptheriae (2)?
(1) cysteine-tellurite agar, dark BLACK, slightly iridescent. (2) Loffler's medium -- cytoplawsmic metachomatic granules after stain w/ aniline dye.
how does maconkey prevent the growth of gram positives?
colistin / polymyxin kills what? spares?
kills most gram negatives, but spares neisseria.
blood agar w/ bile & hypertonic saline used to..
differentiate enterococci (e. faecalis, e. facium; can grow in both) from nonenterococci group D strep (strep bovis / equinus)
Nonenterococcal group D strep grows in..
BILE but not hypertonic saline
Bordet-Gengou medium for...
Bordetella pertusus (whooping cough)
mental status exam testing: comprehension
follow multistep command
mental status exam testing: concentration
months of year backward; serial 7s, world backwards
mental status exam testing: visual-spatial
draw a clock face