pp clues

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Pass Program Clues

You aint told me squat till you

tell me the CLUE!!!

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What are the 5 bacteria causing

Heart Block? Lyme Disease Salmonella typhii (typhoid)

Chagas Disease (Whipples) Legionella Diptheria

Lets Stop Doing Long Contractions

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What bacteria cause Reiters

Syndrome? Shigella IBD

Crohns ChlamydiaYersina

Reiter & Crohn Saw Yersina and gotChlamyia

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What are the Low Complementbugs causing Cryoglobuniemia?

InfluenzaeAdenovirus

Mycoplasma Hepatitis C EBV

I AM HE

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What are the drugs induced

SLE? Hydralazine INH

Phenytoin Procainamide Penicillamine

Ethosuximide

H I PPPE

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What are the drugs that Blast

the BM?AZT Benzene

ChloramphenicolVinblastine

Vinblastine Anilate Bone Cells

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What are the Comma Shaped

bugs?Vibrio Campylobacter

Listeria H. pylori

Campylobacter Has Very Long CommaGenes

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What is the cresent shaped

protozoa? Giardia lamblia

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What bacteria looks like Chinese

letters? Corynebacter

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What are the TB Rx?

Rifampin Pyrazinamide

INH Ethambutanol Streptomycin

R E S P I

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What are the 6 Low Complementassocs. with Nephrotic Syndrome?

Serum Sickness PSGN

SLE SBE Cryoglobinemia MPGN II

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What drugs Induce p450?

BAG 4 CPR QTS Car Grabs Queens Tets to

Rev Up

Alcoholic doing drugs andstinking up car

Barbiturates Alcohol

Griseofulvin Carbamazapine Rifampin

Quinidine Tetracycline Sulfa drugs

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What drugs Inhibit p450?

I Do SMACKQuinolones

INH Dapsone

Spirolactones Macrolides Amiodarone

Cimetidine Ketoconazole Quinilones

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What drugs are P450

Dependent? Warfarin Estrogen

Phenytoin Theophylline Digoxin

Theo came from war & dig inside WDEPT takingEstrogen & now is Phenytoin

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What disease is a Neutophil

Deficiency? CGD

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What is another name for CGD?

Chronic Granulomatous disease NADPH Oxidase deficiency

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What are the Side effects of

Statins? Myositis Hepatitis

Increased liver enzymes

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What are the painful genital

Lesions? Chancroid Herpes

Lymphogranuloma inguinale

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What is the painful chancroid

lesion due to? Hemophilus ducreyi

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What are the 4 hormones withdisulfide bonds?

Prolactin Insulin

Inhibin GH

I PIG on BONDS

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What are the Hookworms?

Necatur americanis Enterobius vermicularis

Ankylostoma duodenale Trichuris trichurium Ascaris lumbercoides

Strongyloides

Hooks AS NEAT

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What are the X-Linked enzyme

Deficiencies? G6-PD CGD

Pyruvate dehydrogenase Def. Fabrys Hunters

Lesch-nyhan Lesch-Nyhan Hunter Puts Fabrys on G6 Clothes

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What diseases do we screen for

at birth? Please Check

Before Going Home

PKU CAH(Congential

Adrenal Hyperplasia) Biotinidase Galactosemia

Hypothyroidism

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HLA-Antigens

HLA-DR2= Narcolepsy, Allergy, Goodpastures,MS

HLA-DR3= DM, Chronic Active Hepatitis,Sjogrens, SLE, Celiac Sprue

HLA-DR3 & 4= IDDM(Type I) HLA-DR4= Rheumatoid Arthritis, Pemphigus

Vulgaris HLA-DR5= JRA, Pernicious Anemia HLA-DR7= Nephrotic Syndrome(Steroid induced)

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HLA-Antigens

HLA-DR 3 & B8=Celiac Disease HLA-A3= Hemochromatosis(chromo. 6, point

mut.-cysteine>tyrosine)

HLA-B8=MG HLA-B13= Psoriasis HLA-B27= Psoriais(only if w/arthritis) Ankylosing

Spondylitis, IBD, Reiters, PostgonococcalArthritis

HLA-BW 47= 21 alpha Hydroxylas def.(Vit.D)

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What are the actions of

Steroids? Kills helper T-cells & eosinophils Inhibits Macrophage migration

Inhibits Mast cell degranulation Inhibits Phospholipase A Stimulates protein synthesis Stablizes endothelium

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What are the causes ofMonocytosis?

Salmonella (typhoid) TB

EBV Listeria Syphillis

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E. Coli is the most commoncause of what?

UTI Spontaneous bacterial peritonitis

Abdominal abscess CholecystitisAscending cholangitisAppendicitis

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What are the one dose treatmentsfor Gonorrhea?

Ceftriaxone Cefixime

Cefoxine Ciprofloxin Oflaxacin Gatifolxacin

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What is the one dose treatment forChlamydia?

Azithromycin

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What are the Big Mamaanaerobes?

Strep bovis Clostridium melanogosepticus

Bacteriodes fragilis

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What are the Big Mama Rx?

Clindamycin Metranidazole

Cefoxitin

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What big mama bugs areassociated with colon cancer?

Strep. Bovis Clostridium melanogosepticus

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What do you see in the serum withlow volume state?

K+? Decreases

Na+?

Decreases

Cl-? Decreases

pH?

Increases

BP? Increases

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What are psammoma bodies?

Calcified CAs

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In what diseases are PsammoaBodies present?

Papillary carcinoma of the Thyroid Serous cystadenocarcinoma of the ovary

Meningioma Mesothelioma

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What are the Urease (+)Bacteria?

Proteus Pseudomonas

Ureaplasma urealyticum Nocardia species Cryptococcus neoformans H. pylori

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What types of stones areformed from Proteus?

Struvite (90%)

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What type of motility do Proteushave?

swarming

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What are 5 indications ofSurgery?

Intractable pain Hemorrhage (massive)

Obstruction (from scarring) Perforation

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What drugs cause CardiacFibrosis?

Adriamycin (Doxyrubicin) Phen-fen

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What drug is used to tx cardiacfibrosis?

Dozaroxsin

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What is the MCC of any.penia?

#1 = Virus #2 = Drugs

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What is seen in the SalmonellaTriad?

High Fever Rose spots (rash)

Intestinal fire

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What drugs cause Myositis?

Rifampin INH

Predinsone Statins

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What are the 7 Gram -encapsulated bacteria?

Some Strange Killers

Have Pretty Nice

Capsules

Salmonella Strep. Pneumo (gr+)

Klebsiella H. influenza Pseudomonas

Neisseria Cryptococcus

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What is the Jones Criteria forRheumatic Fever?

SubQ nodules Polyarthritis

Erythema marginatum Carditis Chorea

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What are the causes ofEosinophilla?

NeoplasmsAllergies/Asthma

Addisons Dz Collagen Vascular Dz Parasites

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What are the Risk Factors forLiver CA?

Hep B,C,D Aflatoxin Vinyl chloride

Ethanol Carbon Tetrachloride Anyline Dyes Smoking

Hemochromatosis Benzene Schistomiasis

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What are the 9 Live Vaccines?

Measles Mumps Rubella

Oral Polio (sabin) Rotavirus Small pox BCG Yellow fever Varicella

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What are the Killed Vaccines?

SIR Hep A Salk (polio) Influenza

Rubella Hepatitis A

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What are the IgANephropathies?

Henoch-Schoenlein P. (HSP)Alports

Bergers

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What are the Drugs that causeAutoimmune hemolytic anemia?

PCN -methyldopa

Cephalosporins Sulfa PTU

Anti-malarials Dapsone

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What are the drugs that causeAutoimmune thrombocytopenia?

ASA Heparin

Quinidine

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What are the enzymes that showafter an MI?

Troponin I CKMB

LDH

h h f

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What is the first MI enzyme toappear?

Troponin I Appears

Peaks Gone

2 hrs

2 days 7 days

Wh i h 2 d MI

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What is the 2ndMI enzyme toappear?

CK-MB Appears

Peaks Gone

6 hrs

12 hrs 24 hrs

Wh t i th 3 d MI t

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What is the 3rdMI enzyme toappear?

LDH Appears

Peaks Gone

1 day

2 days 3 days

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What bacteria have Silver Stains?

Legionella Pneumocysitis carinii

H. pylori Bartonella henseslae (lymph node) Candida (yeast)

h h lf

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What are the sulfa containingdrugs?

Sulfonamides Sulfonylurea

Celebrex

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What is another name for celebrex?

Celecoxib

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What type of inhibitor is Celebrex?

COX 2 specific

Wh COX 2 ifi d

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What COX-2 specific drug can yougive to a pt with sulfa allergy?

Vioxx (Rofecoxib)

Wh t d i hibit dih d f l t

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What drugs inhibit dihydrofolatereductase?

Pyremethamin/Sulfadiazine Trimethoprim/Sulfamethoxazole

Wh t d P l

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What drugs cause PulmonaryFibrosis?

Bleomycin Bulsufan

Amiodarone Tocainide

Wh t th h

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What are the macrophagedeficiency diseases?

Chediak-Higashi NADPH-oxidase deficiency

Wh t th SE f L d

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What are the SE of Loops andThiazides?

Hyperglycemia Hyperuricemia

Hypovolemia Hypokalemia

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What are the SE of Loop diuretics?

OH DANG Ototoxicity Hypokalemia

Dehydration Allergy Nephritis (interstitial)

Gout

Wh t th l 3 P t li

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What are the only 3 PansystolicMurmurs and when are they heard?

MR

TR

VSD

Decrease oninspiration (^exp)

Increase oninspiration

Decrease oninspiration (^exp)

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Macrophages in various organs

Brain Lung Liver Spleen

Kidney Lymph nodes Skin Bone CT

Mircoglia Type I pneumocyte Kupffer cell RES

Mesangial Dendritic Langerhans Osteoclasts Histiocytes or

Giant cells or Epithelioid cells

Wh t th 7 R h f th

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What are the 7 Rashes of thePalms & Soles?

TSS Rocky Mountain Spotted Fever

Coxsackie A (Hand/Foot & mouth dz) Kawasaki Syphillis

Scarlet Fever Staph Scalded Skin Syndrome

What is seen in e e est icti e

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What is seen in every restrictivelung dz and low volume state?

Tachypnea Decrease pCO2

Decrease pO2 Increase pH

What are the different 2nd

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What are the different 2ndmessenger systems?

cAMP cGMP

IP3/DAG Ca:Calmodulin Ca+

Tyrosine kinase NO

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What is the clue for cAMP?

It is the 90% Sympathetic

CRH (cortisol) Catabolic

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What is the clue for cGMP?

ParasympatheticAnabolic

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What are the clues for IP3/DAG?

Neurotransmitter GHRH

All hypothalamic hormones xc cortisol Used by what and for what? Smooth muscle for contraction

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What is the clue for Ca:Calmodulin?

Used by smooth muscle for contraction bydistention

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What is the clue for Ca+?

Used by Gastrin only

What is the clue for Tyrosine

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What is the clue for TyrosineKinase?

Used by Insulins Used by ALL growth factors

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What is the clue for NO?

NitratesViagra

ANP LPS

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What are the T & B cell deficiencies?

WAS SCID

CVID HIV HTLV-1

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What are the CLUES for WAS?

Thrombocytopenia IL-4

Infection Eczema Decrease IgM

IgE???

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What are the CLUES for SCID?

Framshift/Nonsense mutationAdenosine deaminase deficiency

T-cell>B-cell Bacterial infections Fungal infections

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What are the CLUES for CVID?

Late onset Frameshift/Missense mutation

Tyrosine Kinase deficiency

What are the CLUES for HIV &

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What are the CLUES for HIV &HTLV-1?

T-cell>B-cell CD4 rich

Brain Testicles Cervix

Blood vessels

What are the inhibitors of Complex

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What are the inhibitors of Complex1 of the ETC?

Amytal Rotenone


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Malonate


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Antimycin D


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CN- CO

Chloramphenicol


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Oligomycin

What are the ETC chemical

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What are the ETC chemicaluncouplers?

DNP Free Fatty acids

Aspirin

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What type of uncoupler is Aspirin?

Physical uncoupler

What are the 4 sources of Renal

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What are the 4 sources of RenalAcid?

Plasma Urea cycle

Collecting ducts Glutaminase

What is the one dose tx for

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What is the one dose tx forHemophilus ducreyi?

Azithromycin1 gram po

Ceftriazone250 mg im


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What is the one dose tx forChlaymdia?

Azithromycin1 gram po


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What is the one dose tx forCandidiasis?

Ketoconazole150mg

What is the one dose tx for Vaginal

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What is the one dose tx for VaginalCandidiasis?

Difluccan1 pill


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What is the one dose tx forTrichomonas?

Metronidazole2 grams


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What is the one dose tx forGardnerella?

Metronidazole2 grams

What are the 3 cephalosporins & doses

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used as one dose treatments for

Gonorrhea? Ceftriaxone250 mg im

Cefixime400 mg po

Cefoxitin

400 mg po

What are the 3 Quinolones & dosesd d t t t f

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used as one dose treatments for

Gonorrhea? Ciprofloxacin500 mg po

Ofloxacin400 mg po

Gatifloxacin

400 mg im

What are the 4 enzymes needed to

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What are the 4 enzymes needed tobreak down glycogen?

Phosphorylase (Pi) Debranching enzyme

Alpha-1,6Glucosidase Phosphatase

What are the 2 enzymes needed to

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What are the 2 enzymes needed tomake glycogen?

Glycogen synthase Branching enzyme

Wh t th b hi ?

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What are the branching enzymes?

Glycogen alpha-1,4 glycosyl transferase Glycogen alpha-1,6 glycosyl transferase

What is the rate limiting enzyme in

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a s e a e g e y ethe break down of glycogen?

Phosphorylase (Pi)

What values do you see in

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yobstructive pulmonary dz?

pO2?Normal

pCO2?Normal or increased

pH?

Decreased

What values do you see in

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yrestrictive pulmonary dz?

pO2?Decreased

pCO2?Decreased

pH?

Increased

What type of acidosis do you see

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yp ywith obstructive pulmonary dz?

Respiratory acidosis

What are the Lysosomal Storage

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y gDisease & what is the deficiency?

Fabrys Krabbes Gauchers

NiemannPick Tay-Sachs Metachromatic

leukodystrophy

Hurlers Hunters

galactosidase Galactosylceramide glucocerebrosidase

Sphingomyelinase Hexosaminidase Arylsulfatase Liduronidase Iduronidase sulfatase

What dzs are associated with HLA

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B27?

PsoriasisAnkylosing spondylitis

IBD (Ulcerative colitis) Reiters Syndrome

What HLA is Psorisis w/RA

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/associated with?

HLA-13

What are the Glycogen Storage

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y g gDiseases & the deficiency?

Von Gierkes

Pompes

Coris

McArdles

Glucose6phosphate

14 glucosidase

Debranching enzyme

Glycogen phosphorylase

What are 6 places of the TCA cycle where

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p yamino acids feed in/out?

Pyruvate? Glycine Alanine Serine

Acetyl CoA? Phenylalanine Isoleucine Threonine Tryptophan

Lysine Leucine


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Alpha-KG? Glutamate Glutamine

Succinyl CoA? Phenylalanine Tryptophan Tyrosine


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Fumerate? Proline

Oxaloacetate?Aspartate

Asparigine

What are the 4 steps of B-

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poxidation?

Oxidation7 NADH21 ATP

Hydration Oxidation - 7FADH14 ATP Thiolysis8 AcCoA96ATP

131 ATP2 (to bring itin)

What are the blood gases inneuromuscular disease (= restrictive

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neuromuscular disease (= restrictiveblood gases)? pO2?

Decreased pCO2?

Decreased PCWP?

Decreased (b/c its a pressure problem) Respiratory Rate?

Increased pH?

Increased

SZ?Increased

What are 5 Hormones produced by

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small cell (oat cell) lung CA?

ACTHADH

PTH TSHANP

What Autoimmune Disease has the

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following Autoimmune Antibodies?

Anti-smith

Anti cardiolipinAnti-ds DNA

SLE


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Antihistone?

Drug induced SLE


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Anti-topoisomerase?

PSS (Progressive Systemic Sclerosis)


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Anti TSH receptors?

Graves


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Anti-centromere?

CREST


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Anti-GBM?

Goodpastures

What does Goodpastures have

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antibody to?

Type IV collagen


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Anti-mitochondria?

Primary biliary cirrhosis


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Anti-hair follicle?

Alopecia areata


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Anti-IgG?

Rheumatoid arthritis

What Autoimmune Disease has thefollowing Autoimmune Antibodies?

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Anti-myelin receptors?

MS

What Autoimmune Disease has thef ll b d

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Anti-gliaden?Anti-gluten?

Celiac sprue

What Autoimmune Disease has thef ll b d

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Anti-islet cell receptor?

DM Type I

What Autoimmune Disease has thef ll i A i A ib di ?

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Anti-melanocyte?

Viteligo

What Autoimmune Disease has thef ll i A i A ib di ?

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Anti-ACh receptor?

MG

What Autoimmune Disease has thef ll i A t i A tib di ?

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Anti-ribonuclear protein?

Mixed Connective Tissue dz (MCTD)


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Anti-parietal cell receptor?

Pernicious anemia

What does Pernicious Anemia havetib d t ?

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antibody to?

Intrinsic factor


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Anti-epidermal anchoring proteinreceptors?

Pemphigus vulgaris

What does Pemphigus vulgarish tib d t ?

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have antibody to?

Intercelluar junctions of epidermal cells


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Anti-epidermal basement membraneprotein?

Bullous pemphigoid

What do you see with bulloushi id?

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pemphigoid?

IgG sub-epidermal blisters Oral blisters


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Anti-platelet?

ITP

What does ITP have antibody to?

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y

Glycoprotein IIb/IIIa


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Anti-thyroglobulin?Anti-microsomal?

Hashimotos


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Anti-smooth muscle?Anti-scl-70?

Scleroderma


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Anti-rho (SS-A)?Anti-la?

Sjogrens


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Anti-proteinase? C-ANCA?

Wegeners


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P-ANCA?

Polyarteritis nodosa

What antigen & immunoglobulin isPolyarteritis nodosa associated

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y

with?Hepatitis B antigen IgM

What are the viruses that directly causeCA and which CA do they cause?

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CA and which CA do they cause?

Papilloma virus?Cervical CA

EBV?

BurkittsNasopharyngeal CA HepB & C?

Liver CA

HIV?Kaposis Sarcoma

What are the 7 Nephrotic Patterns seenwith every Vasculitis?

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with every Vasculitis?

Clot in front of renal artery?

Renal artery stenosis Clot off whole renal artery?

Renal failure Inflamed glomeruli?

Glumerulo nephritis Clot in papilla?

Papillary necrosis Clot off medulla?

Interstitial nephritis Clot off pieces of nephron?

Focal segmental GN (HIV, drug use association) Clot off lots of nephrons?

Rapidly Progressive GN

What is the most commonnephrotic disease seen in kids and

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pwhen does it occur? Min. change disease

2 wks post URI

vasculitity leading to rapidlyprogressive glomerulonephrosis?

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progressive glomerulonephrosis?

Goodpastures

What is the most commonmalignant renal tumor in children?

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malignant renal tumor in children?

Wilms tumor

What is the most commonmalignant renal tumor in adults?

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malignant renal tumor in adults?

Adenocarcinoma

What is the most common renalmass?

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mass?

Cyst

What is the most common renaldisease in Blacks/Hispanics?

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disease in Blacks/Hispanics?

Focal Segmental GN

What is the most commonnephrotic disease in adults?

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nephrotic disease in adults?

Membranous GN

Thrombolytics & Inhibitors

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What does tPA, Streptokinase, Urokinaseinhibit?

Aminocaproic acid

What doe Warfarin inhibit?Vitamin K

What does Heparin inhibit? Protamine Sulfate

What is the dosage of tPA?

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IV push? 20mg

Drip? 40mg

What is the dosage forStreptokinase?

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Streptokinase?

IV push? 750K

Drip? 750K

What is Urokinase used for?

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Used ONLY for such things as: Feeding tubes

Central lines Fistulas

What is Alopecia Areata?

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Loss of a patch of hair

What is Alopecia Totalis?

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Loss of ALL hair on head bald

What is Alopecia Universalis?

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Loss of hair on entire body hairless

What is Loffler syndrome?

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Pneumonitis with endocarditis =pulmonary infiltrate with severeeosinophilia

What is Loffler syndrome alsoknown as?

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known as?

PIE syndrome

What are the 5 Parasites associatedwith Loffler Syndrome?

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with Loffler Syndrome?

Necator americanusAnkylostoma duodenale

Shistosomiasis Strongyloides

Ascaris lumbricoides

What happens when a patient is onprednisone for > 7 days?

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prednisone for > 7 days?

Immunocompromised

What are 2 enzymes used by B12?

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Homocystine methyl transferase Methyl malonyl-coA mutase

What does Mitochondrialinheritance mean?

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inheritance mean?

No male transmissionAll females pass it on

Who are 4 pts who would besusceptable to pseudomonas andt h i f ?

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staph infxns? Burn patients Cystic fibrosis

DM Neutropenic patients

In a neutropenic patient, what doyou cover for?

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you cover for?

cover 1x for Staph aureus during 1st week cover 2x for Pseudo after 2nd week

What are the 3 main conceptscausing a widened S2 splitting?

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causing a widened S2 splitting?

Increased pO2 Delayed opening/closing of the pulmonary

value

Increased volume in the right ventricle

What are causes for a widenedS2 splitting?

Blood transfusion

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Blood transfusion

Increased Tidal Volume Giving O2 Right sided heart failure Pregnancy due to increase volume IV fluids ASD/VSD Deep breathing Hypernateremia SIADH

Pulmonary regurge Pulmonary stenosis Right bundle branch block

What are the 8 common cavities ofblood loss?

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b ood oss

Pericardium Intracranial Mediastinum

Pleural cavity Thighs Retroperitoneum Abdominal cavity

Pelvis

What is the special list forPenicillin?

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Gram + Basement membrane suppressor Works on simple anaerobes

The #1 cause of anaphylaxis Causes interstial nepritits Causes nonspecific rashes

Acts as a hapten causing hemolytic anemia

What is the #1 cause ofanaphylaxis?

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p y

Penicillin

What are the Chrons Gifts?

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Granuloma Ileum

Fistula Transmural Skip Lesion

What are the negative-strandedRNA Clues?

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RNA Clues?

Prodromal periodbefore symptoms =1-3 weeks

Why is there a prodromal period? Because must switch to positive stranded

before replication

What are the clues for positivestranded RNA?

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Symptoms within 1 week or less EXCEPTIONS: Hanta

Ebola Yellow fever They are -ve stranded = dont have to switch to

positive before replicating

What are the Most commoncyanotic heart diseases?

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y

Transposition of the great arteries Tetrology of Fallot Truncus Arteriosus

Tricuspid Atresia Total anomalous pulmunary Venous Return

Hypoplastic Left heart syndrome

Ebsteins anomaly Aortic atresia Pulmonary atresia

What cyanotic heart disease isboot shaped?

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p

Tetrology of Fallot

What cyanotic heart disease isassociated with mom taking lithiumduring pregnancy?

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during pregnancy? Ebsteins Anomaly

What things make the membraneless likely to depolarize?

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y p

Hypokalemia Hypermagnesemia

Hypercalcemia (except atrium) Hypernatremia

What things make the membranemore likely to depolarize?

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y p

Hyperkalemia Hypomagnasemia

Hypocalcemia (except atrium) Hyponatremia

What is Plan F?

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TPPThiaminB1 Lipoic AcidB4

CoAPantothenic acidB5 FADRiboflavinB2 NADNiacinB3

What are the 8 x-linked inheriteddiseases?

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Brutons Agammaglobulinemia CGD (NADPH def) DMD

Color Blindness

G6PD Hemophilia Lesch-Nyhan

Vit D resist. Rickets (X-linked dominant) Fabrys Hunters

What are the 7 B-cell deficiencies?

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Brutons agammaglobulinemia CVID (Common Variant Imm. Def) Leukemias Lymphomas SCID WAS Job Buckley Syndrome

What is the Tyrosine kinasedeficiency?

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Brutons agammaglobulinemia

What are the B-cell deficiencieswith T-cell overlap?

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SCID WAS

Job Buckley Syndrome

What are the 4 itchiest rashes?

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Scabies Lichen Planus

Urticaria Dermatitis Herpetiformis

Tumor Markers/Oncongenes I

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L-myc? Small cell lung Ca

C-myc?

Promyelocytic leukemia (Burkitts lymphoma)

N-myc? Neuroblastoma Small cell lung CA

C-able? CML ALL

Tumor Markers/Oncongenes II

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C-myb? Colon CAAML

C-sis ? Osteosarcoma

Glioma Fibrosarcoma

Tumor Markers/Oncongenes III

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C-erb B2? Epidermal growth factor receptors

CSF-1 ? Breast

Tumor Markers/Oncongenes IV

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Erb-B2? Breast CA Ovarian CA

Gastric CA

Ret? Medullary CA of thyroid

Men II & III Papillary carcinoma

Tumor Markers/Oncongenes V

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Ki-ras? Lung CA Colon CA

Bcl-2? Burkitts Follicular lymphoma

Erb? Retinoblastoma

What are 6 Hormones producedby the placenta?

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hCG Inhibin Human placental lactogen (HPL)

Oxytocin (drug lactation, pit gland prod italso) Progesterone Estrogen Relaxin

What is cancer grading?

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Severity of microscopic change Degree of differentiation

What is cancer staging?

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Degree of dissemination of tumor What the surgeon sees

What are the rashes associatedwith cancer and what cancer arethey associated with?

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they associated with?

Urticaria/Hives? Any CA, especially lymphoma Pagets Ds (ulcers around nipples)

Seborrheic keratosis (waxy warts)? Colon CA HIV if sudden increase in number

Normal with aging

What are the rashes associatedwith cancer and what cancer arethey associated with?

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they associated with?

Actinic keratosis? Dry scaly plaques on sun-exposed skin

Squamous Cell CA of skin

Dermatomyositis? violacious, heliotropic rash, malar area

Colon CA

What are the rashes associatedwith Cancer and the cancer theyare associated with?

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are associated with?

Akanthosis nigricans? dark lines in skin folds

Any visceral CA

End organ damage

Erythema nodosum? ant aspect of legs, tender nodules

Anything granulomatous

NOT assoc. w/ bacteria

What is carried by HDL?

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Apo EApo A

Apo CII

L-CAT lecithin cholesterol acetyl transferase

Cholesterol from periphery to liver

What is carried by VLDL?

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Apo B-100 Apo E Apo C II

Triglcyerides (95%) Cholesterol (5%)

What is carried by IDL?

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Apo B-100Apo E

Apo CII

Triglycerides (< VLDL)

Cholesterol (>VLDL)

What is carried by LDL?

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Apo B-100

Cholesterol

from liver to tissue

NOT a good thing!!!!!

What do chylomicrons carry?

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Apo AApo B-48Apo E

Apo C II

Triglycerides from: GI to liver (25% of the time)

GI to endothelium (75% of the time)

Which lipoprotein carries themost cholesterol?

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LDL

Where are the AVMs?

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Clue = HEAL Heart? Machinery murmur

Elbow? Fistula from dialysis in renal disease

Abdomen/Brain? Von Hippel-Lindau = clot off with coils Increase incidence of Renal cell CA on chrom 3

Lungs? Osler Weber Rendu Syndrome

What is the Ransons criteria foracute pancreatitis (at admission)?

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Glucose > 200Age > 55 LDH >350AST > 250 WBC > 16,000

What is the Ransons criteria foracute pancreatitis (at less than48 hrs)?

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) Calcium 10% O2 < 60 (PaO2) Base deficit > 4 BUN > 5 mg/dl

Sequestration > 6L

What 2 diseases is pilocarpineused for?

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CF Glaucoma

Painful, red, teary eye

What is dysguzia?

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Problem with sense of taste

What are 3 causes of dysgusia?

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Metronidazole Clarithromycin Zinc deficiency

What is the triad of Carcinoidsyndrome?

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Flushing Wheezing diarrhea

What do you measure for carcinoidsyndrome?

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Serotonin 5-HIAA

Where are the 2 most commonplaces a carcinoid tumor isfound?

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found? Pancreas Ileum

What are the phage mediatedtoxins?

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Mnemonic: BEDS Botulinum Erythrogenic toxin

from strep pyogenes

Diptheria

Salmonella Has O antigen

What is the story used toremember the segmented RNAviruses?

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I sprayed ORTHOon my BUNYAat theARENAdown in REOto killSEGMENTED WORMS

Name the 3 major types ofadhesion molecules

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ICAMs Integrins Selectins

What does IgCam do?

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Bind proteins

What do integrins do?

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Stop the leukocytes

What do selectins do?

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Bind carbohydrates Mediate the rolling to slow leukocytes

down

What are the functions of adhesionmolecules?

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Homing of lymphocytes tells lymphocytes where to go

Inflammation Cell-cell interaction

Primary allergic response is dueto what?

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Contact

What cells are present in the first 3days?

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Neutrophils

The next cells to show up are? B-cells

What do B-cells make? IgM

What day does IgM show up?

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Three

IgM peaks at what day? 14

When does IgM leave? In 2 months

What shows up in 2 wks (14 days)?

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IgG

When does IgG peak? In 2 months

When does IgG leave? In 1 year

What is Secondary Allergicresponse is due to?

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MEMORY

What shows up at day 3?

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IgG with 5x concentration Has the highest affinity

When does IgG peak? In 5 years

When does IgG leave? In 10 years

What Ig has the hightest affinity?

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IgG

What are the risk factors forEsophageal/Gastric CA?

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SmokingAlcohol Nitrites Japanese

What are the risk factors forbladder CA?

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Smoking Aniline dyes Benzene Aflatoxin

Cyclophosphamide Schistosomiasis 2 diseases: Von Hippel-Lindau

Tubular sclerosis

What is the NBT test?

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Nitro Blue Tetrazolium test What is it used for? Screening CGD What does ave test indicate? +ve for the disease

What disease corresponds with thefollowing inclusion bodies?

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Howell-Jolly? Sickle cell

Heinz?

G-6-P-D

Zebra? Niemann pick


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Donovan? Leishmaniasis

Mallory? Alcoholism

Negri?

Rabies


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Councilman?Yellow fever

Call-exner? Ovarian tumors

granulosa origin


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Lewy? Parkinsons

Pick? Picks disease

Barr body?

Normal female


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Aschoff? Rheumatic fever

Cowdry type A inclusions? Herpes virus

Auer rods? AML


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Globoid? Krabbes lysosomal storage disease

Russell? Multiple myeloma


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Schiller-Duvall?Yolk sac tumor

Basal bodies? Only found in smooth mm

What are the 4 types ofhypersensitivities?

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Mnemonic? ACID

Type I Anaphylaxis/Atopic

Type II Cytotoxic (Humoral)

Type III Immune complex mediation

Type IV Delayed hypersensitivity/Cell mediated

What are the Characteristics ofType I hypersensitivity?

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Atopic IgE (Asthma) binds to mast cell IgA activates IP3 cascade degrading mast

cells

What are the Characteristics ofType II hypersensitivity?

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Humoral What are examples of type II? Rh disease GoodpasturesAutoimmune hemolytic Anemia

All Autoimmune diseases except RA and SLE

What are the Characteristics ofType III hypersensitivity?

b l

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Ag-Ab complement What are examples of Type III? RA SLEVasculitides

Some GN?

What are the Characteristics ofType IV hypersensitivity?

C ll di d

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Cell mediated What are examples of Type IV? TB skin test Contact dermatitis Transplant rejection

What structures have no knownfunction?

A di

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Appendix Epithalamus Palmaris longus

muscle

Pancreatic polypeptide hormones in F-cells

What diseases can progress toRPGN?

G d t

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Goodpastures Wegeners DM HTN

What are causes of papillarynecrosis?

V liti

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VasculitisAIDS

Cytic fibrosis Questions?

T ?

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Tx? Pilocarpine also used for glaucoma

Test used to detect CF?

Pilocarpine sweat test

What ion does this test measure? Cl-

Definitive presence of disease has a test value of what? >60

Cytic fibrosis Questions?

Wh t i th l i l ?

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What is the value in a normal person?

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Bacillus anthracis Clostridium perfringens Clostridium tetani Clostridium melangosepticus

What is the chemical in spores? Calcium dipocholinate

What does strep mutansferment?

L ti id

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Lactic acid

What type of receptors do allsphincters in the body have?

Al h t

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Alpha-receptors

Strep. Salivarius ag is used forwhat test?

C ld l ti i t ti

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Cold agglutinin testing IgM

Types of amyloid found in variousSystemic amyloidoses:

AA l id?

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AA amyloid? Chronic active disease

AL amyloid from Ig light chain? Myeloma


Beta 2 mic oglob lin?

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Beta 2 microglobulin? Chronic hemodialysis

AA amyloid from SAA? Nephrotic hereditary forms

eg. Mediterranean fever


Pre albumin/transthyretin?

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Pre-albumin/transthyretin? Cardiomyopathic hereditary forms

senile systemic amyloidosis

Neuropathic hereditary syndromes

Types of amyloid found in variousLocal amyloidoses:

ANP fibrils are caused by?

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ANP fibrils are caused by? Senile cardiac amyloisosis

Cerebral amyloid in Alzheimers disease/Downs? Cerebral amyloidosis

Types of amyloid found in variousLocal amyloidoses:

Calcitonin precursors?

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Calcitonin precursors? Medullary CA of thyroid

AL from light chains? Isolated, massive, nodular deposits lung, skin, urogenital tract

What type of dementia do youget in Picks dis?

Frontotemporal dementia

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Frontotemporal dementia

Describe Picks disease

Atrophy of frontal and temporal cortex

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Atrophy of frontal and temporal cortexwith sparing of remaining neocorticalregions

What 3 things do Pick bodiescontain?

Altered neurofilaments

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Altered neurofilaments Tau protein ubiquitin

What drugs can cause adisulfiram reaction?

Mnemonic?

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Mnemonic? CLAM

Chloramphenicol Lactams

Cefamandole

CefoperazoneAntabuse

disulfiram

What is the mode of action of theClostridium botulinum toxin?

Prevents pre synaptic release of Ach

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Prevents pre-synaptic release of Ach

How do babies get it? From spores in honey or molasses

How do adults get it? From canned food

What are 3 Toxins of Bacillus?

Lethal factor (black necrosis)

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Lethal factor(black necrosis) Protective factor Edema factor

Who has Poly-D Glutamic acid?

Anthracis

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Anthracis Cereus

Name that B-blocker:

B1 selective?

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B1-selective?AM Non-selective?

NZ Exceptions? Carbetalol and Labetolol are non-selective

What are the 4 facts of FanconiSyndrome?

Problem in proximal tubule

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Problem in proximal tubule Cant reabsorb Low energy state causing anemia

Can be due to old tetracycline

Where is glutaminase found?

In the collecting duct of the kidney

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In the collecting duct of the kidney

What does glutmainase help the kidneyabsorb?

Ammonia if the liver fails

Name 3 anatomical spots whererenal stones get stuck:

Hilum

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Hilum Pelvic brim Entering the bladder

Renal failure is the most commoncause of death in what 3 diseases?

SLE

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SLE Endometrial CA Cervical CA

What is the rate-limiting enzymein the urea cycle?

Carbamoyl synthase I

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Carbamoyl synthase I

Where is it found 90% of the time?

Liver

Where is it found 10% of the time? Collecting duct of the kidney

What type of charge doesheparin have?

ve charge

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-ve charge

What type of charge doesprotamine sulfate have?

+ve charge

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+ve charge

What is it used for? Reversing the effects of heparin

What is commonly seen in allvasculitides?

T-cells and macrophages

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T cells and macrophages Schistocytes Decreased platelets Decreased RBCs

Bleeding from mucosal surfaces Bleeding from skin and GI Petechiae Ecchymoses

What happens if you expose theblood to the basement membrane?

The following deveop:

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The following deveop: Clots DIC

Pulmonary embolism DVT MI

Stroke

Signs and symptoms in allvasculitides

Tachypnea and SOB

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Tachypnea and SOB

Most common cause of death?

Heart failure

What is the MOA of Erythromycin?

Inhibits the translocation step of ribosomalt i th i

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Inhibits the translocation step of ribosomalprotein synthesis

What is the MOA ofChloramphenicol?

Inhibits ribosomal peptidyl transferase in

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Inhibits ribosomal peptidyl transferase inprokaryotes

What is the MOA of Puromycin?

Inhibits elongation by binding to A site

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Inhibits elongation by binding to A siteand prematurely terminating chain growthin pro and eukaryotes

What is the MOA of Streptomycin?

Causes misreading of code during

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Causes misreading of code duringinitiation in prokaryotes

What is the MOA of Tetracycline?

Prevents binding of aminoacyl-t-RNA to

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Prevents binding of aminoacyl t RNA toribosome on prokaryotes thereforeinhibiting initiation

What is the MOA ofCyclohexamide?

Inhibits ribosomal peptidyl transferase in

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Inhibits ribosomal peptidyl transferase ineukaryotes

cell wall inhibitor

What is the MOA of Rifampin?

Blocks B-subunit of RNA polymerase

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Blocks B subunit of RNA polymerase Prophylaxis for contacts of N. meningitidis

What is the MOA of Vancomycin?

Cell wall inhibitor

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Cell wall inhibitor Binds irreversibly to Phopholipase carrier Bacteriacidal

Covers all gram +ves Linezolid

What is the MOA of Warfarin?

Blocks vitamin k dependent gamma-

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Blocks vitamin k dependent gammacarboxylation of prothrombin and factors2, 7, 9, 10, proteins C & S

What is the MOA of Clindamycin?

Blocks translation by binding the 50S

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Blocks translation by binding the 50Ssubunit

Hemolytic properties ofStreptococcus:

What type of hemolysis is alpha hemolysis? Partial hemolysis

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yp y p y Partial hemolysis

What color is its zone?

Green

What type of hemolysis is beta-hemolysis? Complete hemolysis

Hemolytic properties ofStreptococcus:

What color is its zone

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What color is it s zone Clear

eg. Streptokinase

What type of hemolysis is gamma-hemolysis? No hemolysis

What color is its zone? Red

What are the 5 notable thingsabout RTA I?

High urine PH (??????not sure about this)

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g u e ( ot su e about t s)Acidosis UTI s

Stones Babies die < 1 yr old

What are 3 notable things aboutRTA II?

Acidosis

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urine PH = 2, normal is 5-6

Hypokalmia

Patients have NO carbonic anhydrase

What are 3 notable things aboutRTA III?

It is a combination of RTA I & III

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Normal urine pH Hypokalemia

What are 3 notable things aboutRTA IV?

Seen in diabetics

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Hyperkalemia NO aldosterone b/c JG apparatus has

infarcted

What are the members ofStreptococcus Group D?

Viridans

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Mutans Sanguis

Salivarius Bovis

What Steptococcus has greenpigment?

Viridans

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What Streptococcus causesSBE?

Viridans

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What Streptococcus causescavities?

Mutans

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What do you see in NephriticSyndrome?

HTN

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Hematuria RBC casts

What do you see in NephroticSyndrome?

Increase Edema

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Increase Lipidemia Increase Cholesterolemia

Increase Coagulability Decrease serum Albumin Increase urinary Albumin

What is the #1 cause of Sinusitis,Otitis, Bronchitis, Pneumonia?

Strep. Pneumo

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p

What is the #2 cause?

Hemophilus influenza

What is the #3 cause? Neisseria meningitides

What is the #1 method toparalyze cilia?

Viruses

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Which are secondary to what?

Bacterial infections

What is the #2 method to paralyze cilia? Smoking

If you develop gastroenteritiswithin 8hrs of eating what are themost common likely bugs?

Staph aureus

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p Clostridium perfringens Bacillus cereus.from what?

Fried rice

Gastroenteritis within 8hrs of eatingwhat toxin?

Preformed

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What does Clostridum tetaniinhibit?

Release of glycine from spinal cord

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What physical finding would you see? Lock jaw

What is the tx? Antitoxin and Toxoid

Where is it injected? Injected in different areas of body

The Most common cause of UTI is?

E. coli

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Followed by?

Proteus

Followed by? Klebsiella

The most frequent cause of UTI infemales between 5-10?

Staph saprophyticus

Why?

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Why? They stick things in themselves

18-24 yoa?

Staph saprophyticus Why? Because they stick things inside themselves

Why no UTIs after 24?

Because women are use to penises and Staph saprophyticus lives onpenis (becomes part of normal flora).

Staph aureus is the mostcommon cause of what bonedisease?

Osteomyelitis

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Because of what?

Collagenase

What is the Most Common cause ofinfections one week post burninjury?

St h

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Staph. aureus

What is the triad of SSSS?

ShockR h

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Rash Hypotension

Most common cause of UTI?

E. coliTh ?

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Then? Proteus

Then? Klebsiella

Newborn meningitis is causedby?

Group B Strep (agalactiae)E li

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E. coli Listeria

What is normal rectal flora frommom

Group B Strep (Strep. Agalactiae)E li

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E. coli Listeria

What is associated with colonCA?

Clostridium melanogosepticus St b i

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Strep bovis

What color pigment is produced? Black

What Ig do you look for withaffinity?

IgG

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What about Avidity?

IgM

What is transduction

Virus inject its DNA into bacteria

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What is transformation?

Virus injects its DNA into it bacteria in ahospital or nursing home setting then

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hospital or nursing home setting, thenbecomes deadly.

Conjuction occurs only withwhat?

Bacteria with Pili

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What causes mutiple cerebralabscesses in newborns?

Citrobacter

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What are the 2 gramves that arestrict anaerobes?

Hemophilus influenza Neisseria

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Neisseria

What type of complement problemdo you have in recurrent infectionswith encapsulated organisms?

C3

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C3

What does complement fightagainst?

Gram negative bacteria

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Gram negative bacteria

What do you see in serum withprerenal failure and what are thevalues?

BUN >20

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>20

Fractional Na+ excertion 40

What do you see in Renal failureand what are the values?

BUN 10-15

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10 15

Fractional Na+ excretion >2%

Creatinine

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Margination Diapediesis

Migration

What is the rate limiting enzymefor Glycolysis?

PFK-1

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PFK-1

What is the rate limiting enzyme ofGluconeogenesis?

Pyruvate Carboxlyase

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Pyruvate Carboxlyase

If treating a disease that initiatesthe cell mediated response, whatare you treating first?

Viral

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If resistant to tx, what next?

Fungal Mycobacterium Protozoa Parasite Neoplasm

What bugs can you pick upduring birth?

Step. Group B Strep agalactiae

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Strep agalactiae

Strep. Pneumonia

Herpes simplex virus Neisseria gonorrhea Chlyamydia

What is another name forAdenoma sebaceum?

Perivascular angiofibromata

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Perivascular angiofibromata

What is another name forAddisons?

Primary Adrenocoritcal Insufficiency

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What is another name forAlkaptonuria?

Ochronosis

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What is another name forChurg-Strauss?

Allergic Granulomatosis Angiitis

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Angiitis

What is another name forCraniopharyngioma?

Ameloblastoma

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What is Ameloblast?

Tooth material

What is another name forChrons?

Regional enteritis Granulomatous ileitis

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Granulomatous ileitis

Ileocolitis

What is another name forDeQuervains?

Subacute Granulomatous Thyroiditis

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What is another name forIntraductal Ca?

Comedo Ca

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What is another name for I-CellDisease?

Mucolipidosis II

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What is another name forKawassaki Disease?

MLNS Mucocutaneous Lymph Node Syndrome

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Mucocutaneous Lymph Node Syndrome

What is another name forLeydig cells?

Interstitial cells

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What is another name forSertoli cells?

Sustentacular cells

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What is another name forTemporal arteritis?

Giant cell arteritis (granulomatous)

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What is another name forWaldenstroms macroglobulinemia?

Hyperviscosity syndrome

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HHV I causes?

Oral Trigeminal ganglia

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g g g

HHV II causes?

Genital Sacral plexus

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p

HHV III causes?

Varicella zoster

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HHV IV causes?

EBV Mononucleosis

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Burkitts

HHV V causes?

CMV Inclusion bodies

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HHV VI causes?

Roseola Duke Disease

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Exanthem subitum

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HHV VIII causes?

Kaposis sarcoma

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Answer the following questionsabout Coumadin/Warfarin.

What is the MOA? Interferes with normal synthesis and gamab l ti f Vit K d d t l tti

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carboxylation of Vit. K dependent clottingfactors via vitamin K antagonism.

Is it long or short acting? Long half-life 8-10 hours to act


Clinical use? Chronic anticoagulation

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Contra-indication? Pregnancy because it can cross the

placenta


What pathway does it affect? Extrinsic pathway

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What does it do to PT? Prolongs

PT


What are the toxicities? Bleeding

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Teratogenic

Drug-drug interactions

How is it activatied?

Tissue activated


Administration? po

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What are the Vitamin K dependentclotting factors?

IIVII

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IX

X Protein C Protein S

Answer the following questionsabout Heparin.

What is the MOA? Catalyzes the activation of antithrombin IIID th bi d X

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Decreases thrombin and Xa

Is it long or short acting? Short half-life Acts immediately


Clinical use? Immediate anticoagulation of pulmonary

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embolism, stroke, angina, MI, DVT.

Contra-indication? Can be used during pregnancy because it

does not cross the placenta


What pathway does it affect? Intrinsic pathway

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What value should you follow? PTT


What are the toxicities? Bleeding

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Thrombocytopenia

Drug-drug interactions

How is it activatied?

Blood activated


Administration? I.V.

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Drug of choice for what? DVT


What is good about the newer low-molecular-weight heparins?h

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They act more on Xa

Have better bioavailability Have 2 to 4 times longer half life Can be administered subcutaneously and

without laboratory monitoring.

What do you use for rapid reversalof heparinization?

Protamine sulfate

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How do you treat Lead Poisoning?

Dimercaprol

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How do you treat Benzodiazepinepoisoning?

Flumazenil

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How do you treatAnticholinesterase poisoning?

Pralidoxime

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How do you treat Iron poisoning?

Deferoxamine

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How do you treat Opioid poisoning?

Naloxene

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How do you treat Barbituatepoisoning?

Bicarbonate

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Doxapram

What does Doxapram do?

Activates the respiratory center in thebrain

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What is the treatment forHypercholesterolemia?

ProvostatinAtrovastatin

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Lovastatin

Simvastatin

What statin is renally excreted?

Provastatin

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What statins do you have to followliver enzymes every 3 months?

Atrovastatin LovastatinS

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Simvastatin

What do statins inhibit?

HMG-CoA reductase

Wh i i i ?

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When is it most active?

8:00pm on

If statins are insufficient what doyou add?

Cholestipol Cholestyramine

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If nothing works what do you give? Probucol Niacin

What are the side effects of Niacin?

Flushing Itching

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What 2 statins bind bile salts?

Cholestipol Cholestyramine

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What are 4 causes of severepain (in order)?

1.Pancreatitis Due to What? ETOH

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2.Kidney stones Due to What?Alcohol

What are 4 causes of severepain (in order)?

3.AAA How is this described?

Ri i i d b k

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Ripping pain down back

4.Ischemic bowel What is symptom?

Bloody diarrhea

What are 5 causes of SIADH?

Small cell Ca of lung Increased intracranial pressure P i ( t )

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Pain (most common)

Drugs Hypoxic Lung Disease/Restrictive Lung

disease

What drug causes SIADH?

Carbamazepine

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What are the cells of neuralcrest origin?

Parafollicular cells of thyroid Odontoblasts (predentin) Pseudounipolar cells

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Spiral membrane of heart

Chromaffin cells All Ganglion cells (Schwann, Adrenal medulla) Melanocytes

Laryngeal/Tracheal cartilage

What are the triple repeatdiseases?

Huntingtons Fragile X Myotonic Dystrophy

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Myotonic Dystrophy

Prauder Willie Spinal/bulbar muscular atrophy (Fredicks

ataxia)

How do you determine themaximum sinus rate?

220 - age

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What are the 3 low volume stateswith acidosis rather than alkalosis?

RTA Diarrhea Diabetic ketoacidosis (DKA)

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Diabetic ketoacidosis (DKA)

What are the causes of Croup &Bronchiolities?

ParainfluenzaAdenovirus Influenza

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Influenza

RSV

What is asthma in a child lessthan 2 called?

Bronchiolitis

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What are the 4 Ds of Pellagra?

Diarrhea Dermatitis Dementia

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Dementia

Death

What are the uric acid stones?

Cysteine Ornithine Lysine

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Lysine

Arginine

What is happening in theAtrium?

Phase 0? Depolarization

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Phase 1?

No name

Phase 2?

Plateau phase (A-V node)

What is happening in theAtrium?

Phase 3? Repolarization

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p

Phase 4?Automaticity (S-A node)

What do Na+ channels do tothe EKG?

Wider QRS

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What does Ca+ do to the EKG?

Wider P-wave Longer PR interval

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What are the types of kidneystones?

Calcium oxalate (phosphate) stones Struvite stones Uric acid stones

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Uric acid stones

Cysteine stones Oxalate stones

What percent of kidney stones arecalcium oxalate?

80%

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If you find oxalate stones in thefollowing what should you think of?

3 y/o white male? CF

/ bl k l ?

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5 y/o black male?

Celiac Sprue

If you find oxalate stones in thefollowing what should you think of?

Adult male? Whipples

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Adult male or female? Crohns

If oxalate stones found in CF whatis the most common cause?

In 0-20 y/o? Malabsorptin

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What age do they die?Young

Answer the following questionsabout pseudogout?

What type of crystals are present? Calcium pyrophosphate

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Where are they found? Joint spaces

Answer the following questionsabout pseudogout?

Who gets it? Older patients M=F

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Tx? Colchicine

What are the most common non-cyanotic heart disease?

VSDASD PDA

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PDA

Coarctation

What murmur increases onexpiration?

VSD Mitral

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What murmur has fixed widesplitting?

ASD

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What murmur has boundingpulses?

PDA

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What gives you differenitalpulses?

Coarctation

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What is increased incidence inTurners?

Coarctation

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What are 4 enzymes never seenin glycolysis?

Pyruvate carboxylase PEP carboxykinase F-1,6 dPhosphatase

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F 1,6 dPhosphatase

G-6-Phosphatase

What are 3 enzymes seen ONLYin glycolysis?

Hexokinase PFK-1 Pyruvate kinase

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y u ate ase

What are 2 hormones that areacidophilic?

Prolactin GH

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What are the partially acid fastGram +ve?

Nocardia

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What are the partially acid fastProtozoa?

Cryptosporidium

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What are the septic emboli ofSBE?

Mycotic aneurysm Roth spots Janeway lesions

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y

Oslers nodes Splinter hemorrhages Endocarditis

Where are the following lesionsfound?

Janeway lesions? Toes

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Oslers nodes?

Fingers

Roth spots?

Retina

What is the most common cause ofendocarditis?

Strep. viridans

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What causes microsteatosis?

Acetaminophen

Reye Syndrome Pregnancy

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g y

What causes macrosteatosis?

Alcohol

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What are 2 bacteria that releaseelastase?

Staph. Aureus

Pseudomonas

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What are the 2 bacteria with toxinsthat inhibit EF-2?

Pseudomonas

Diptheria

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How does Diptheria work?

It ADP ribosylates EF2 inhibiting proteinsynthesis

Is it Gram +/ ?

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Is it Gram +/-?

+

Where and how does it get its exotoxin?

From virus via transduction

How does Diptheria work?

What does it cause? Heart block

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What do you give for Tx?Antitoxin

Never scrape membrane

What are the different types ofEmphysema and their causes?

Bullous? Staph aureus Pseudomonas

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Centroacinar? Smoking

What are the different types ofEmphysema and their causes?

Distalacinar?Aging

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Panacinar?Alpha-1 antitrypsin def

What are the stages oferythropoiesis?

4 mo gestation?Yolk sac

6 mo gestation?

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6 mo gestation?

Spleen, liver, flat bones

What are the stages oferythropoiesis?

8 mo gestation? Long bones

1 yr old?

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1 yr old?

Long bones

If long bones become damagedafter 1 yr what takes over?

Spleen can resume erythropoieses causingsplenomegaly

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What ions correspond with thefollowing EKG?

P-wave? Ca+

QRS l ?

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QRS complex? Na+

S-T? Ca+

What ions correspond with thefollowing EKG?

T-wave? K+

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U-wave? Na+

What do Na+ channel blockersdo to the EKG?

QRS

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What do Ca+ channel blockersdo to the EKG?

Widens P-wave PR interval longer

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P.P. Clue 4 Bio StatD W

+ B A+B

_ C C+D

A

D

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A+C B+D ALL

Sensitivity A/A+C

Specificity D/B+D

PPV A/A+B

NPV D/C+D

OR AD/BC

RR (A/All)/(C/All)

AR (A/All)-(C/All)

Sensitivity: Truly Diseased People

Specificity: Truly Well People

+ Predictive Value: Test +ve With DZ

-Predictive Value: Tested

ve w/o DZOR: Odds Ratio

RR: Relative Risk

AR: Attributed Risk

Always in the

numerator

A&D

In EKG P-wave Represents?

Atrium contraction Phase zero Calcium

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In EKG P-R Interval means?

AV Node Phase 2 Sodium

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In EKG Q-Wave means?

Septum Phase 2 Sodium

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In EKG R-upstoke means?

Anterior wall Phase 2 Sodium

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In EKG S-down stroke means?

Posterior wall Phase 2 Sodium

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In EKG S-T Interval means?

Ventricle Phase 2 Calcium

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In EKG T-wave means?

Ventricle Phase 3 Potassium

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In EKG U-wave means

Ventricle Phase 4 Sodium

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4 DZ associated with HLA-DR 2?

NarcolepsyAllergy (hay fever) Goodpasture

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MS

5 DZ associated with HLA-DR 3?

DM Chronic active Hepititis Sjogrens

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SLE Celiac sprue

DZ associated with HLA-DR 3&4?

IDDM (DM Type 1)

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DZ associated with HLA-DR 4?

Rheumatoid Arthritis Pemphigus Vulgaris

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DZ associated with HLA-DR 5

JRA (JUV RA) Pernicious anemia

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DZ associated with HLA-DR 7?

Nephrotic syndrome (Steroid induced)

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DZ associated with HLA-DR 3and HLA-B 8?

Celiac Disease

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DZ Associated with HLA-A3?

Hemochromatosis chromosome 6

point mutation Cystine to Tyrosine

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DZ Associated with HLA-A 3?

Myasthenia gravis

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DZ Associated with HLA-B 13?

Psoriasis

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5 DZ Associated with HLA-B 27?

Psoriasis only if with arthritis

Ankylosing Spondylities

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IBD Ulcerative Cholitis Reiters

Post gonococcal arthritis

DZ Associated to HLA-BW 47

21 alpha hydroxylase deficiencyVit. D

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Facts about Diphtheria

ADP ribosylates EF-2 Stops cell synthesis Gr +ve Gets exotoxin from virus via transduction

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Gets exotoxin from virus via transduction

Heart block Its toxoid therefore give antitoxin

MCC of Pneumonia in 6wks to18 yrs?

RSV (infants only) Mycoplasma Chlamydia pneumonia

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Strep pneumonia

MCC Pneumonia in 18 yrs to 40 yrsof age?

Mycoplasma Chlamydia pneumonia Strep. Pneumonia

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MCC of Pneumonia in 40 yrs to65 yrs of age?

Strep pneumonia H. influenzaAnaerobes

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MCC of pneumonia in the Elderly?

Strep pneumoniaVirusesAnaerobes

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H.influenza Grve rods

What are 4 Clues for IgA?

Monomer in blood Dimer in secretion Located on mucosal surface

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Found in secretion

What are Clues for IgD?

Only functions as surface marker forMature B-Cell

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What are Clues for IgE?

Immediate hypersensitivity/anaphylaxis

Parasite defense Worms Fc region binds to mast cells and basophils

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g p

Allergies Does Not fix complement

What are Clues for IgG?

Highest affinity

Memory respond at day 3five times the concentration Peaks in 5 years last for 10 years Opsonizes Activates complement 2nd to show up in primary response

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2 to show up in primary response

Only one to show up for secondary respond Most abundant Ig in newborn Antigenic differences in heavy chain and site of di-sulfide

bond

4 subclasses G1 to G4

What are Clues for IgG1?

Crosses placenta due to fc portion

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Most common sub-class deficiency Patient susceptible to encapsulated

organisms

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Most memoryantibody

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Only IgG NOT fixing complement

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What are Clues for IgM?

Responds in primary response Most efficient in agglutination and

complement fixation

Defenses against bacteria and viruses

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Defenses against bacteria and viruses

What do Macrophages release?

MHC II

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What does TH1 secrete?

IL-2 IF- Gamma

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What does TH2 Secrete?

IL-4 IL-5 IL-6

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IL-10

What does TH-0 secrete?

TH-1 TH-2

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MHC-1 are also called what?

CD8 CD8 becomes T-cytotoxic cells

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All T-Cells express what?

CD-3 For what? Signal transduction

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CD-2 For what?

Adherence

What do CD-4 cells Become?

T helper cells

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What do CD-8 cells Become?

T cytotoxic cells

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Neutrophils produce what enzymesand what is their action?

Myeloperoxidase NADPH Will kill ALL Gr+ve

Ex..Hydrogen peroxide kills gr+

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y g p g

What do T-cells stimulate?

Clue 4x7=28

CD-4

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B-7 CD-28

What are the Clues for Type-1Hyperlipidemia?

Increased Chylomicron Deficiency of Lipoprotein lipase enzyme Defect in liver only

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What are the Clues for type-2hyperlipedimia?

Increased LDL

Two types IIa and IIb Type IIa Receptor deficiency for LDL or missing

B-100

Type II-b (LDL and VLDL problems) enzyme

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yp ( p ) ydeficiency for LDL at adipose. Receptor problemfor VLDL. Most common in General Population

What are the Clues for type-3Hyperlipedimia?

Increased IDL Receptor problem for APO-E

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What are the Clues for Type-4hyperlipedimia?

Increased VLDL Lipoprotein lipase enzyme deficiency at

adipose tissue

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What are the Clues for Type-5hyperlipedimia?

Combination of Types 1&4 Increased Chylomicron and VLDL Enzyme and receptor deficiency at C-II

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Most common in diabetics

What is a Xanthoma?

Deposition of Cholesterol on elbows Can cause what? CAD

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What is a Xanthelasma?

Deposition of Triglycerides on eyelids, face

Can cause what? Pancreatitis

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Description ofRashes

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ERYTHEMA MARGINATUM

Little red spots w/ bright red margins

Sandpapery RF- Jones critera

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ERYTHEMIA CHRONICUMMIGRANS

Lymes disease

Target lesions (bulls eye)

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MEASLES

Morbiliform rash

Preceded by cough conjunctiivitis

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ROSEOLA

Fever x 2 day

Followed by rash ONLY ONE WITH RASH FOLLOWING

FEVER (HHV 6)

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ERYTHEMA NODOSUM

Anterior aspect of leg

Redness Tender nodules

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Erythema multiforme

Red macules, target lesions

Causes: allergy, viruses Mild: MCC virus, #2 drugs (sulfas) Moderate: Stevens-Johnsons Syndrome

S T i id l l i ki

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Severe: Toxic epidermal necrolysis , skinpeels off

SEBORRHEIC DERMATITIS

Scaly skin with oily shine on headline

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SEBORRHEIC KERATOSIS

Stuck on warts

Due to aging

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PSORIASIS

HLA-B27

Extensor surfaces Silvery white plaques

Scaly skin

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Pitted nails

VARICELLA ZOSTER HHV 3

STAGES

Red macules Papules Vesicles

P t l th b

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Pustules then scabs Different stages may appear at same

time

DERMATITIS HERPATIFORMIS

Rash and blisters on ant. thighs

Assoc. with diarrheaAssoc. with flare up of celiac sprue

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TYPHOID FEVER

SEEN WITH SALMONEALLA INFXN

Rose spots assoc. with intestinal fire

7/27/2019 PP clues

495/849

DERMATOMYOSITIS

Heliotropic rash

7/27/2019 PP clues

496/849

ERYSIPELAS

Reddened area on skin w/ raised borders

DOES NOT BLANCH

7/27/2019 PP clues

497/849

TINEEA CRURIS

Redness

Itchy groin

7/27/2019 PP clues

498/849

PITYRIASIS ROSEA

Herald patch= dry skin patches that followskin lines

HHV 7

7/27/2019 PP clues

499/849

TINEA VERSICOLOR

Hypopigmented macules on upp

pp clues

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