Test 18 Flashcards

(56 cards)

1
Q

sore throat, malaise, lymphadenopathy, myalgias, slenomegaly, fever

A

infectious mono

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2
Q

This virus infects the pharpyngeal mucosa and tonsillar crypts, gains access to the blood stream, preferentially infects B lymphocytes by binding to CD21.

A

EBV

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3
Q

How does the IS respond to EBV infected cells?

A

CD8 T cells (cytotoxic T lymphocytes), clonally expand expand to destroy virus infected cells

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4
Q

Larger cells w/ abundant cytoplasm and eccentrically placed nucleus + cell membrane that conforms to the borders of neighboring cells

A

Atypical lymphocytes seen in EBV

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5
Q

What cell surface marker is expressed on monocytes and mphages and serves as a receptor for LPS (LPS binding to this receptor activates the mphage)

A

CD14

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6
Q

What do the cardinal veins give rise to?

A

SVC and other constituents of the venous circulation

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7
Q

What happens to the umbilical veins, vitelline and cardinal veins during development?

A

umbilical veins= degenerate

vitelline veins= become the veins of the portal system

cardinal veins= veins of systemic circulationg

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8
Q

What is the main mechanism by which increases in myocardial O2 demand are satisfied?

A

Hypoxia and adenosine accumulation increase cardiac perfusion

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9
Q

Where does most coronary venous blood drain into?

A

coronary sinus in the right atrium (the remainder drains into the chambers of the heart

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10
Q

What three features distinguish heart circulation from blood flow to skeletal muscle and viscera?

A
  1. Heart is perfused during diastole and consumes 5% of CO
  2. Myocardial O2 requirement is high (extracts 90%)
  3. Coronary flow is regulated by local metabolic factors (hypoxia and adenosine accumulation)
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11
Q

What part of the heart is prone to ischemia?

A

endometrium

Myocardial contraction during systole compresses the coronary arteries and disrupts blood flow (contraction is highest in the endocardium leading to severe coronary vessel compression)

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12
Q

Hypo-hyperpigmeneted skin patches that become more visible after tanning

A

Malassezia furfur causes PITYRIASIS VESICOLOR (stratum corneum)

*more common in hot humid climates

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13
Q

KOH scraping show spaghetti and meatballs on light microscopy

A

Malassezia furfur

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14
Q

Two toxins act by ribosylating and inactivating EF2, inhibiting host cell protein synthesis and causing cell death?

A

Diptheria toxin= C. Diptheriae

Pseudomonal exotoxin A= Exotoxin A

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15
Q

Superantigen that acts locally in the GI tract causing vomiting

A

Enterotoxin= S. Aureus

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16
Q

Superantigen that stimulates T cells leading to widespread cytokine release and shock (IL-1, TNF alpha)

A

TSS toxin

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17
Q

Induces actin depolymerization leading to mucosal cell death, necrosis of colonic muscosal surfaces and pseudomembrane formation

A

Toxin B= C. Diff

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18
Q

Blocks presynaptic release of Ach at NM jxn resulting in flaccid paralysis

A

Botulinum toxin= c. botulinum

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19
Q

Disinhibits AC via G ADP ribosylation> increased cAMP> increased histamine sensitivity and phagocyte dysfxn

A

Pertussis toxin= bordatella pertussis

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20
Q

Acitvates AC via G ADP ribosylation> increased cAMP> secretory diarrhea, dehydration, electrolyte imbalances

A

cholera toxin= v. cholerae

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21
Q

Unconscious manifestations of neurologic sxs w/ no pathophyisiological manifestations often after significant life stress

A

converseion disorder

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22
Q

most lateral of hte distal carpal bones, thumb “swings on it”

A

trapezium

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23
Q

What bone lies at the center of hte wrist?

24
Q

What bone is located at the proximal medial wrist and with the lunate forms the small articular surface between teh ulna and carpal bones?

25
What type of fall classically causes lunate dislocation?
fall on oustretched hand
26
cause of avascular necrosis of proximal scaphoid fx fragment
lunate dislocation that also causes fx of scaphoid
27
Noninfective glycoprotein component of HVB envelope that forms spheres and tubules 22 nm in diameter
HBsAg (secreted by infected hepatocytes)
28
Nucleocapsid core protein taht resides in hepatocytes and assembles virion
HBcAg
29
Nucleocapsid core and precore protein that is a marker of high infectivity. Core component resides in hepatocytes and assembles virion, while precore is secreted in the blood
HBeAg
30
TRanscriptional transactivaitor of viral gens from X region that is necessary for viral replication
HBx
31
What type of mutations results ina glutamate residue being substituted by lysine in the beta globin chain?
Missence mutation causing hemoglobin C (HbC in both beta chain) Hb A> HbS> HbC
32
1 HbS allele and 1 HbC allele Asymptomatic pt w/ mild hemolytic anemia and splenomegaly
Hemoglobin SC disease
33
Mental retardation, facial dysmorphism, cardiac defects
Down Syndrome (usually caused by extra chromosome 21-- trisomy)
34
What are other less common cuases of Down Syndrome?
Robertsonian translocations mosaicism
35
What is a Robertsonian translocation?
46 chrom, but extra arm of chrom 21 is attached to another chrom (translocation)
36
How can mosaicism cause Downs?
Pts have 2 cells lines: one w/ a normal genotype and one w/ trisomy 21 (no maternal association, post fertilization mitotic error)
37
Causes of secondary hyperaldosteronism
renovascular disease malignant HTN renin secreting tumors
38
HyperTN, hypokalemia and muscle weakness can be attributed to...
elevated serum adlosteorne levels
39
Increased renin and aldosterone
secondary hyperaldosteronism
40
A pt who is a known HBV carrier presents to your office w/ malaise, weight loss and abdominal fullness. CT reveals a liver mass and increased AFP.
Hepatocellular carcinoma
41
carcinoma assocaited w/ HBV infeciton
Hepatocellular
42
What triggers neoplastic changes in HBV?
integration of viral DNA into genome of host hepatocytes
43
Increased incidence of Burkitt lymphoma and nasopharyngeal carcinoma
EBV infection | see atypical lymphocytes on blood smear CD21
44
measure of association between exposure and outcome
Odds ratio
45
Formula for OR?
OR= ad/bc
46
RR formula
a/ (a+b)/ c/ (c+d) risk of disease in hte exposed divided by risk of disease in the non exposed
47
Difference in risk between exposed and unexposed
AR A/ (a+b) - c/ (c+d)
48
Bean shaped gram negative cocci that causes meningitis
N. meningitidis
49
How does N. meningitidis gain access to the CNS?
``` respiratory droplets> colonizes nasopharynx> bloodstream> choroid plexus> meninges ```
50
What is the second MC cause of acute bacterial meningitis in adults in the US?
N. Meningitidis
51
Which neisseria ferments maltose and glucose?
MeninGococci ferment Maltose and Glucose
52
meningococcemia meningitis WF syndrome
n. meningococci
53
Pharynx> lymphatics> meninges
H. Influenza meningitis in infants and children
54
Middler ear> contiguous tissues> | meninges
S. Pneumoniae gains acces to CNS during acute ear infection
55
Traumatic wound> leak CSF> meninges
S. Aureus meiningitis/CNS abscess (fullowing penetrating skull trauma or neurosurgery)
56
Primary lung focus> blood > meninges
Myobacterium TB meningitis or S. pneumoniae meningitis