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Pages 17-36 CNS “TOM” Butyrophenone Atypical D4 Flumazenil Methylphenidate Phenytoin Thiopental Carbamazepine Atypical D4-r Pimozide Risperidone Thioridazine Haloperidol Imirpamine Clomirpramine Trazadone Bupropion SSRIs Fluoxetine Phenelzine Lithium Alprazolam Propranolol -r -r Morphine & O2 Morphine Morphine OD Meperidine Hydromorphone Tramadol Naloxone Pentazocine Butorphenol Nalbuphene GABA Fast Na Ch. Methoxyflurane Enflurane Isoflurane Halothane Nitric Oxide Thiopental Kentamine Droperidol Fentanyl 1. 2. 3. 4. 5. Short –acting BDZs: Triazolam Onazelam Midazolam Haloperidol & Droperidol 6. Clozapine – Thioridazine – Olanzepine – Risperidone = Do not cause EPS 7. BDZ antidote for OD 8. Txt attention deficit disorder 9. Causes aplastic anemia/ gingival hyperplasia/ cleft lip & palate 10. Short acting Barb 11. DOC trigeminal neuralgia. Txt lennox gestaut seizures in kids 12. Thioridazine; Olamzapine; Clozapine 13. Txt Tourette’s 14. Good for negative symptoms 15. Most anti cholinergic neuroleptic 16. Neuroleptic malignant hyperthermia due to chronic D2 block. give Dantrolene and Bromocriptine 17. Enurisis 18. Txt OCD See aggressive behavior w/ use 19. Priapism 20. Helps to quit smoking 21. Primarily used for OCD 22. Good for negative symptoms 23. Irreversible MAOI 24. 25. 26. 27. 28. Txt manic phase of Bipolar Disorder Causes goiter by (-) conversion of T4 to T3 Nephrogenic diabetes insipidus Low salt diet will lead to Li toxicity DOC stage fright 29. Social phobia 30. Spinal analgesia. Euphoria. ++euphoria. ++sedation. Constipation. 31. Supraspinal analgesia. Dysphoria. +respiratory depression. +sedation. 32. Admin. is contraindicated to pts on morphine sedation= CO2 sensitivity and O2 admin. can stop breathing. 33. ICP = do not give to pt. with head trauma 34. 1.pinpoint pupils 2.’d respiraiton 3.coma 35. Anesthetic used during labor 36. (+) used in renal failure 37. Ambulatory txt for mod. to severe pain 38. Txt opioid OD. Reverses respiratory depression 39. Part (+) & part (-) 40. Part (+) & part (-) 41. Part (+) & part (-) 42. seizure focus= Barbs & BDZs 43. electrical activity spread = Phenytoin & Carbamazepine 44. Can be nephrotoxic. Needs low MAC for anesthetic induction. 45. Can cause tonic/clonic muscle spasms 46. Can cause bronchospasm 47. Can cause ventricular extrasystoles & Malignant hyperthermia & Hepatitis 48. No effect on HR. Needs high MAC for anesthetic induction. 49. Short acting Barb. 50. Dissociative anesthetic 51. Can be used in combo w/ Fentanyl for neuroleptoanalgesic effect 52. Neuroleptic tranquilizer. Has mild alpha block 53. Can be used on combo w/ Droperidol for neuroleptoanalgesic effect Page 1 Midazolam Primidone C & A delta Fibers Esters Amides Amphetamine Bromocriptine Benztropine Amantidine Diphenhydramine Pergolide Ethosuximide Tranylcypromine SSRI & MAOI Labor opioids Desipramine causes 54. Used transdermally for chronic pain 55. Pre anesthetic. Induces amnesia 56. Biotransformed to Phenobarb. 57. First fibers to be blocked w/ anesthesia 58. 59. 60. 61. 62. Procaine, Tetracaine, Benzocaine Broken down and make PABA (allergen) Lidocaine, Mepivaciane, Bupivaciane, Etidocaine= “i” before “caine” always an amide Metabolized in the liver DA reuptake (-)’r. MAOI. Parkinson’s txt 63. D2(+). Used w/ L-Dopa for “on-off” phenomenon of Parkinson’s 64. Ant M w/ some DA reuptake (-). Parkinson’s txt 65. DA reuptake. Can cause livido reticularis= skin mottling. 66. Txt early Parkinson’s stages 67. > Effective & longer acting than Bromocriptine 68. DOC for Absence seizures 69. MAOI = antidepressant 70. Fatal combo, especially seen with the use of Paroxetine or Fluoxetine (SSRIs) and Tranylcypromine (MAOI) 71. Meperidine & Nalbuphine 72. Sudden cardaic death in children Anti-Infective 1. 2. 3. Malaria profylaxis Used for extraerythrocytic forms Plasmodium vivax or P. ovale Quinolone derivative Hepatic coma DOC 4. 5. 6. 7. 8. 9. 10. 11. Clavulanic acid 12. Piperacillin 13. 14. 15. PABA structural analogs Inhibit Folic acid synthesis Should not be used in anuric pt due to production of (-) Nitrogen balance & d BUN levels. Doxycycline is the exception 3rd generation cephalosporin DOC for bacterial meningitis in kids (ie… HiB) One dose txt of gonorrhea Neomycin (aminoglycoside) – it supresses the normal flora = g NH4 production = g free nitrogen levels in the bloodstream. Irreversible (-)r of lactamases, but ot of transpeptidase = use w/ a lactamase sensitive penicillin Txt Pseudomonas aeruginosa & Klebsiella Broad spectrum antibiotic Txt Mycobacterium tuberculosis 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. Most commonly used drug for TB. Usually combined w/ Rifampin and/or Ethambutol Pre Txt w/ Pyridoxine (Vit B6) can prevent peripheral neuritis‘ Txt of Hookworm disease Depolarizing NMJ (-)r A = Aminoglycosides T = Tetracyclines C = Chloramphenicol E = Erythromycin (macrolide) L = Clindamycin L = Lincomycin Txt intraabdominal infections (ie… w/ Bacteroides fragilis) Traditional txt has been Clindamycin & Gentamycin Broad spectrum antibiotic Bone marrow depression (common) – Aplastic anemia (rare) Gray baby syndrome (chloramphenicol cannot be conjugated) DOC Typhoid Fever (symptomatic Salmonella infection) DOC HiB meningitis in kids – especially resistant strain to ampicillin Txt trypanosomiasis Primaquine Ciporfloxacin Sulfonamides Tertacyclines, anuria & the exception Ceftriazone Streptomycin (aminoglycoside) Isoniazid Pyrantel Pamoate Buy “AT” 30, “CELL” at 50 Cefoxitin Chloramphenicol Nifurtimox Metronidazole 35. Txt Leishmaniasis & Amebiasis Page 2 Txt P. carinii Tetracycline TMP-SMX Benzathine Penicillin G Praziquantel Melarsoprol Stibogluconate Fluconazole Amphotericin B Ketoconazole MOA Griseofulvin MOA Mefloquine 36. 37. 38. 39. Good for anaerobic bacteria = Bacteroides fragilis DOC Trichomoniasis DOC Giardia lamblia TMP-SMX & Pentamidine 40. 41. 42. 43. Txt of Brucellosis & Cholera Txt Rocky Mountain Spotted Fever Txt spirochete infections = Lyme disease (Borrelia burgdorferi) (-) dihydrofolate reductase activity 44. Long duration of action = given once every 3-4 weeks for Txt of Syphilis 45. Txt Schistosomiasis (trematode [fluke] infections) 46. Txt Trypanosomiasis that has neurological symptoms 47. Txt Leishmaniasis 48. Txt fungal encephalitis 49. Polyene antifingal 50. (-) fungal ergosterol synthesis = disrupts membrane 51. Accumulates in keratinized layers of the skin = used in dermatomycoses infections 52. Anti malarial 53. Txt Chloroquine resistant strains = P. falciparum 54. Txt for Malaria when inside RBC Chloroquine Nifurtimox Erythromycin Nystatin Acyclovir 55. DOC Chagas disease due to Trypanosoma cruzi 56. Used in pts allergic to penicillins 57. Topical txt of superficial mycotic infections = Candidiasis Imipenem Cefoperazone side effects Vancomycin Meropenem Nafcillin Peripheral neuropathy Sulfonamides & newborns “O.N.E.” for gonorrhea Ribavirin 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. Guanine analog Txt Herpes infections Used w/ Cilastatin Can cause seizures Bleeding due to vit K level alterations Contraindicated in pts w/ bleeding disorders Used for MRSS (methicillin resistant Staph. Aureus) “Red neck”: due to histamine release causes facial flushing used w/ Cilastatin Does not cause seizures (cf w/ Imipenem) Only penicillin that does not need dose adjustment in renal impairment 69. Seen w/ use of: 70. Metronidazole – Isoniazid – Vincristine – ddI – AZT – Allopurinol 71. Kernicterus can occur 72. 73. 74. 75. 76. Fluoroquinolones used in a one dose deal for gonorrhea: O = Ofloxacin N = Norfloxacin E = Enoxacin Txt RSV (Respiratory Syncytial Virus) Anti-Neoplastics Cyclosporine Cyclophosphamide Cisplatin’s toxicities Methotrexate Leucovorin Rescue Bleomycin toxicities Azathiorine MOPP 77. 78. 79. 80. 81. Protects against rejections from organ transplants Does not induce bone marrow depression Alkylating agent of both purine & pyrimidine bases of DNA Txt CLL Nephro- & Ototoxicity 82. Antimetabolite of folic acid: (-)dihydrofolate reductase 83. Can block/reduce Methotrexate = folic acid via a reduced folate 84. Pneumonitis & pulmonary fibrosis 85. 86. 87. 88. 89. 90. Used in organ transplantation = kidney allografts Allopurinol can its activity by (-) its biotransformation to xanthine oxidase Chemotherapy used in the txt of Hodgkin’s disease M = Mechlorethamine – nitrogen mustard O = Oncovin (Vincristine) – prevents microtubule assembly P = Procarbazine Page 3 Tamoxifen Flutamide Megestrol Fluoxymesterone Methotrexate Brain tumor Txt Streptozocin Cytarabine (AraC) Dactinomycin Etoposide Paclitaxel Amifostine 91. 92. 93. 94. 95. 96. 97. 98. 99. 100. 101. 102. 103. 104. 105. 106. 107. 108. 109. 110. P = Prednisone – glucocorticoid, inducing apoptosis (-) estrogen receptor Txt of breast tumors, can see associated endometrial CA Antiandrogenic Used w/ Leuprolide (LH-RH analog) Txt prostatic CA (-) progesterone receptor Txt endometrial CA Androgenic steroid Txt mammary CA in postmenopausal women Folic acid analog that (-) tetrahydrofolate synthesis by (-) dihydrofolate reductase Txt of ALL Txt of Psoriasis Lomustine Carmustine – Causes pulmonary fibrosis Attaches to cells Txt of pancreatic insulinomas Pyrimidine analog DOC for AML Used for Wilms tumor & rhabdomyosarcoma 111. Used for oat cell CA 112. Used for ovarian CA 113. Can nephrotoxicity due to chronic use of Cisplatin Path Mobitz I Mobitz II P wave a wave T wave Wavy fibers Janeway’s lesions Osler’s nodes Thiamine defcy Fibrinous Pericarditis Serous Pericarditis Friction Rub Hemorrhagic Pericarditis Restrictive Cardiomyopathy PML’s infectious agent Edema Adult Polycystic Kidney Disease Malignant HTN & Kidneys Nephritic signs Nephrotic signs 114. Usually due to inferior MI. Rarely goes into 3rd degree block. 115. Txt w/ Atropine or Isoproterenol. 116. BBB association. Often goes to 3rd degree AV block. Usually due to anterior MI. 117. Atrial depol. 118. LA contraction 119. Vetricular repol. 120. Eosinophilic bands of necrotic myocytes. Early sign of MI. 121. 122. 123. 124. 125. 126. 127. 128. Acute bacterial endocarditis. Nontender, erythematous lesions of palms & soles. Subacute bacterial endocarditis. Tender lesions of fingers & toes. Wet Beri Beri heart. Dilated (congested) cardiomyopathy due to chronic alcohol consumption Dyr Beri Beri = peripheral neuropathy Wernicke-Korsakoff = ataxia; confusion; confabulation; memory loss Associated w/ MI: Dressler’s 129. Associated w/ nonbacterial; viral (Coxsackie) infection; immunologic reaction. 130. Pericarditis association 131. Associated w/ TB or neoplasm 132. 133. 134. 135. Aka infiltrative cardiomyopathy that stiffens the heart Due to amyloidosis in the elderly Due to , also see schaumann & asteroid bodies in young (<25 yoa). JC Virus (Papovavirus = dsDNA, naked icosahedral capsid) 136. 137. 138. 139. 140. 141. Pc (more seeps out) c (less reabsorbed) permeability Block lymphatic drainage Commonly see liver cysts & Berry aneurysms along w/ kidney cysts. Hematuria & HTN also present. 3 cysts in ea. Kidney w/ + family history confirms diagnosis 142. Petehial hemorrhages are seen on kidney surfaces = Flea-Bitten surface = young black men 143. Hematuria; RBC casts; HTN 144. Proteinuria; Hypoalbuminemia; Edema Page 4 Podocyte Effacement seen w/ ASO seen in Crescentic GN Hereditary Nephritis Membranoproliferative GN TypeI Membrano Proliferative GN deposits TypeII Membrano Proliferative GN deposits Focal segmental glomerulosclerosis deposits Cold agglutinins Scrofula Aspirin-Asthma Triad Ferruginous bodies Pancoast’s tumor causes Fatty degeneration Cloudy swelling Hydropic degeneration Liquefaction necrosis Coagulation necrosis Caseation necrosis Fibrinoid necrosis Fat necrosis Hemoptysis Pulmonary embolism Phlebothrombosis Saddle embolus Paradoxical embolism Tuberculoid granuloma Cellulitis PSA 5-HT Feto Protein CEA Chromosome 13 Chromosome 11p Vinyl Chloride 145. Minimal Change (Lipoid nephrosis) disease 146. 147. 148. 149. 150. 151. 152. 153. 154. Acute post-streptococcal GN (due to HGASrtep) Anti streptolysin O Rapidly progressive GN – nephritic syndrome Associated w/ multi system disease or post-strep/post infectious glomerular nephritis Alport’s syndrome. X linked Renal disease w/ deafness & ocualr abnormalities Can be secondary to complement deficiency; chronic infections; CLL See tram tracking C3 & IgG deposits 155. Only C3 deposits 156. Aka Dense deposit disease 157. IgM & C3 deposits 158. Seen in atypical pneumonia 159. It is IgM Ab with specificity for I Ag on adult RBCs 160. TB in the lymph nodes 161. Nasal polyps – Rhinitis – bronchoconstriction 162. Hemosiderin (pigment w/ Fe3-) covered macrophages that have been pahgocytised 163. Ulnar nerve pain & Horner’s syndrome 164. 165. 166. 167. 168. 169. 170. 171. 172. 173. 174. 175. 176. 177. 178. 179. 180. 181. 182. Made up primarily of triglycerides Most commonly due to alcoholism which commonly leads to hepatic cirrhosis Associated w/ CCl4Failure of cellular Na pump Seen in Fatty degeneration of the liver and in Hydropic (Vacuolar) degeneration of the liver Severe form of cloudy swelling Seen with hypokalemia induced by vomitting/diarrhea Rapid enzymatic break down of lipids Seen commonly in Brain & Spinal cord (CNS) injuries Seen in suppurative infections = pus formation Result of sudden ischemia Seen in organs w/ end arteries limited collateral circulation) = heart, lung, kidney, spleen Combination of both coagulation & liquefaction necrosis Seen w/ M. tuberculosis & Histoplasma capsulatum infection Seen in the walls of small arteries Associated w/ malignant hypertension, polyarteritis nodosa, immune mediated vasculitis Result of lipase actions liberated from pancreatic enzymes Seen w/ Acute pancreatitis = saponification results Blood in sputum 183. Most commonly thrombus from lower extremity vein 184. 185. 186. 187. 188. 189. 190. 191. 192. From a vein of lower extremities, of a pregnant uterus, in Congestive heart failure, bed ridden pt, As a complicaiton in a pt w/ Pancreatic CA due to d blood coagulability Embolus lodged in bifurcation of pulmonary trunks RV strain = RV & RA dilate = Acute cor Pulmonale Right to Left shunt allows a venous embolism to enter arterial circulation Patent ovale foramen or Atrial septal defect Collection of macrophages w/o caseation Seen w/ Sarcoidosis (non-caseating); Syphilis; Brucellosis and Leprotic infections Spreading infection due to streptococcus 193. Prostate Specific Antigen = elevated in prostatic CA 194. In cases of metastatic carcinoid, txt w/ Methysergide (5HT antagonist) 195. Hepatocarcinoma 196. Neural tube defects 197. Carcinoembryonic Antigen = elevated in Colon CA 198. Retinoblastoma 199. Wilms tumor of the kidney 200. Associated w/ Angiosarcoma of the liver Page 5 Agent Orange Parasites & CA Ochronosis Lead poisoning Heroin OD, clinically Fetal alcohol syndrome Atypical mycobacterium Cold abscesses Actinomyces isrealli Congenital Syphilis Warthin-Finkeledy cells Diphyllobothrium latum Subacute Bacterial Endocarditis Acute Bacterial Endocarditis Mitral Insufficiency Left Anterior Descending branch Left Circumflex branch Dissecting Aneurysm Cor Pulmonale Acute Cor Pulmonale Bronchopneumonia Lobar pneumonia Bronchiectasis Cold Agglutinins Panlobular Emphysema Bulla Farmer’s Lung Bagassosis Silo-Filler’s Lung 201. Contains dioxin 202. Implicated as a cause of Hodgkin;s disease, non-Hodgkin’s lymphoma & soft tissue sarcomas 203. Schistosoma haematobium = Urinary bladder CA 204. S. mansoni = Colon CA 205. Aspergillus flavus = potent hepatocarcinogen 206. Alkaptonuria 207. Error in tyrosine metabolism due to Homogentisic acid (oxidizes tyrosine) 208. Involving intervertebral disks = Ankylosing Spondilitis = Poker spine 209. See dark urine; dark coloration of sclera, tendons, cartilage 210. Acid fast inclusion bodies 211. urinary coproprophyrin 212. Anemia: microcytic/ hypochromic 213. Stippling of the basophils 214. Gingival line & lead line in bones: x-ray 215. Mental retardation 216. Massive pulmonary edema w/ frothy fluid from the nostrils 217. Small head, small eyes, funnel chest, ASD, mental deficiency, and hirsutism 218. M. kanasasii & M. avium intracellulare 219. Liquefied TB lesions similar to pyogenic abscesses but lacking acute inflammation 220. Farmers infection 221. Lumpy jaw (from chewing grain) & PID (IUD), but most common is due to saprophyticus 222. Saddle nose, Saber shin, Hutchinson’s teeth, nerve deafness, interstitial keratitis 223. Reticuloendothelial giant cells on tonsils, lymph nodes, spleen 224. Seen with Rubeola (measles) due to paramyxovirus 225. Tapeworm infection causing megaloblastic anemia by consuming large amount of vit B12 in the host 226. Hemolytic Streptococci (S. viridans) = usually in pt w/ pre-existing heart problem 227. Staph aureus, Hemolytic Streptococci, E. coli 228. Common among drug addicts & diabetics 229. Ruptured papillary muscle 230. Branch of the Left Coronary artery 231. Highest frequency of thrombotic occlusion 232. MI = anterior wall of the LV, especially in apical part of interventricular septum 233. Branch of the Left Coronary artery 234. Occlusion = MI of posterior/lateral wall of the LV 235. False aneurysm: it is splitting of the media of the aorta 236. Usually accompanied w/ long history of severe hypertension, also seen w/ familial hyperlipidemia, atherosclerotic disease, Marfan’s Collagen disease 237. Zones of medial necrosis +/- slitlike cysts = Medial Cystic Necrosis of Erdheim 238. Right ventricular strain, associated w/ right ventricular hypertrophy 239. Sudden right ventricular strain due to a massive pulmonary embolism 240. Lobular (rather than lobar) 241. Due to Staph aureus; Pseudomonas aeruginosa; Klebsiella; E. coli 242. Abscess formation is common 243. Due to Strep. Pneumoniae infection (5% due to Klebsiella) 244. Red Hepatization: days 1-3 of the pneumonia 245. Gray Hepatization: days 3-8 of untreated pneumonia 246. Complicaitons: pleural effusion; atelectasia; fibrinous pleuritis; empyema; fibrinous pericarditis; otitis media 247. Permanent dilatation of the bronchi – predisposed by chronic sinusitis and post nasal drip 248. Supparation associated 249. Lower lobe > than upper lobe involvement 250. Found w/ Mycoplasma pneumoniae 251. 1 – antitrypsin deficiency, causing elastase = compliance in the lung 252. Associated w/ Emphysema = “Bleb” = outpouching - If it ruptures causes Pneumothorax 253. Due to Micropolyspora faeni (thermophilic actinomycetes) 254. Due to M. vulgaris (actinomycetes) 255. Inhalation of sugar cane dust 256. Due to Nitrogen dioxide from nitrates in corn Page 6 G6PDH Deficiency HbF Multiple Myeloma Hodgkin’s Disease Polyarteritis Nodosa Sprue Regional Enteritis Whipple’s Disease Kulchitsky cells Ulcerative Colitis Vaginal Adenosis Scirrhous Carcinoma Hofbauer Cells Retinopathy of Prematurity IgA deficiency Priamry Sjorgen’s Secondary Sjorgen’s LDH1 & LDH2 LDH3 LDH4 & LDH5 Keratomalacia Metabisfite Test Microangiopathic Hemolytic Anemia Wright’s stain Mononucleosis T(8;14) T(9;22) Langerhan Cell Histiocytosis Myeloid Metaplasia Multiple Myeloma T(14;18) Focal Segmental GN exs Nephrotic Syndrome exs Schistosoma Haematobium 257. Sex-linked chronic hemolytic anemia w/o challenge or after eating fava beans 258. Heinz Bodies appear in RBCs 259. Sickle Cell Anemia 260. Lytic lesions of flat bones (“salt & pepper lesions”) = vertebrae, ribs, skull; Hypercalcemia; BenceJones protein casts 261. Malignant neoplasm of the lymph nodes causing pruritis; fever = looks like an acute infection 262. Reed Sternberg cells 263. Immune complex disease of Ag-Ab complexes on blood vessel wall 264. Half of the immune complexes have Hepatitis B Ag 265. Can see fever; abd.pain; wt; HTN; muscle aches 266. Celiac disease due to a gluten-induced enteropathy = small intestine villi are blunted 267. High titers of anti-gliadin Abs & IgA levels 268. Crohn’s Disease 269. Association w/ Arthritis; Uveitis; Erythema Nodosum 270. Intestinal Lipodystrophy = malabsorption syndrome 271. Neural cest cells from which carcinoids arise = of the Bronchi; GIT; Pancreas 272. Inflammatory disease of the colon w/ colon CA incidence 273. Crypt abscess in the crypts of Lieberkuhn 274. Pseudopolyps when ulcers are deep 275. Not transmural involvement 276. Women exposed to DES (Diethylstilbesterol) in utero before the 18 th week of pregnancy 277. Some develop clear cell adenocarcinoma of the vagina & cervix 278. Infiltrating Duct Carcinoma w/ fibrosis – most common type of breast carcinoma 279. Lipid laden macrophages seen in villi of Erythroblastosis Fetalis 280. Retrolental Fibroplasia = cause of bindness in premies due to high O2 concentrations 281. Pt has recurrent infections & diarrhea w/ respiratory tract allergy & autoimmune diseases 282. If given blood w/ IgA = develop severe, fatal anaphylaxis reaction 283. Dry eyes & dry mouth, arthritis. risk for B cell lymphoma. HLA-DR3 frequent. Autoimmune disease. 284. Rheumatoid arthritis, SLE, or systemic sclerosis association 285. RA association shows HLA-DR4 286. Myocardium. LDH1 higher than LDH2 = Myocardial Infarction 287. Lung tissue 288. Liver cells 289. Severe Vit A deficiency. See Bitot’s spots in the eyes = gray plaques = thickened, keratinized ET 290. Suspending RBCs in a low O2 content solution 291. Can detect Hemoglobin S, which sickles in low O2 292. Can be due to Hemolyitc Uremic Syndrome & Thrombotic Thrombocytopenic Purpura (TTP) 293. See Helmet cells 294. Stain for Burkitt’s lymphoma 295. Due to EBV infeciton 296. If Mono is treated w/ Ampicillin, thinking that it is a strep pharyngitis, a rash will occur. 297. Burkitt’s lymphoma = c-myc oncogene overexpression 298. CML = c-abl/bcr gene formation = Philadelphia translocation 299. Letter Siwe syndrome; Hand Schuller Christian Disease; Eosinophilic Granuloma 300. Birbeck granules are present = tennis racket shape 301. Alkaline phosphatase /normal compare to CML = low to absent 302. Anemia; splenomegaly; platelets > 1 million = extensive extra-medullary hematopoiesis 303. Weakness; wt. loss; recurrent infection; proteinuria; anemia; proliferation of plasma cells in BM = plasma cell dx 304. Serum M protein spike – most often of IgG or IgA 305. Hypercalcemia ( bone destruction) 306. NH Lymphoma = bcl2 proto-oncogene overexpression seen w/ Small Cleaved Cell (Follicualr) Lymphoma 307. IgA Focal GN = Berger’s disease; SLE; PAN; Schonlein-Henoch purpura (anaphylactoid purpura) 308. Focal (Segmental) GN; Membranous GN; Lipoid (Minimal Change) GN; Membranoproliferative GN; Hep B; Syphilis; Penicillamine 309. Infection is assocaited w/ Squamous cell CA of the Bladder (most common Bladder CA is transitional cell type) 310. Associated w/ portal HTN due to intrahepatic obstruction Page 7 Penicillin Resistant PID Duret Hemorrhages Hypertensive Hemorrhage Cerebral Embolism from Neurosyphilis 5pTrisomy 13 Acute Cold Agglutinaiton Chronic Cold Agglutinaiton RBC Osmotic Fragility Non-Hodgkin’s Lymphomas Singer’s Nodules Paraseptal emphysema Superior Vena Cava Syndrome Betel nuts Fundal (Type A) Gastritis Antral (Type B) Gastritis Primary Biliary Cirrhosis Acute Pancreatitis Radiating Back Pain Complete Hydatidiform Mole Partial Hydatidiform Mole Cold Nodules Acidophils Basophils Lacunar Strokes CSF of Bacterial Meningitis CSF of Viral Meningitis Marble Bone Disease C5a C3b Anaphylotoxins Vasoactive Mediators Platelet Aggregation Platelet Antagonist Intrinsic Pathway Extrinsic Pathway 311. PID is usually due to N. Gonorrhoeae, but if unresponsive to penicillin think of Bacteroides species 312. Severe in ICP w/ downward diplacement of cerebellar tonsils into Foramen Magnum causing a compression on the brainstem w/ hemorrhaging into the pons & midbrain 313. Nearly always associated w/ death due to damage to the vital centers in these areas 314. Predilection for lenticulostriate arteries = putamen & internal capsule hemorrhages 315. MI w/ Mural Thrombi; Atrial Fib Thrombi = Marantic thrombi; L-sided Bacterial Endocarditis; Paradoxical Embolism of septal defect 316. Tabes Dorsalis = joint position sensation, pain sensation, ataxia, Argyl Robertson pupils 317. Syphilitic meningitis 318. Paretic neurosyphilis 319. Cri di Chat: mental retardation; small head; wide set eyes; low set ears; cat-like cry 320. Patau’s: small head & eyes; cleft lip & palate; many fingers 321. Abs to I blood group Ag. Mediated by IgM Abs 322. Complication of EBV or Mycoplasma pneumoniae infections 323. Associated w/lymphoid neoplasms. See agglutination & hemolysis in tissue exposed to cold. IgM Abs 324. Hereditary Spherocytosis 325. Small Lymphocytic: low grade B cell lymphoma of the elderly. Related to CLL. 326. Small Cleaved cell (Follicualr): low grade B cell lymphoma of the elderly. T(14;18) bcl-2 oncogene 327. Large Cell 328. Lymphoblastic: high grade T cell lymphoma of kids progressing to T-ALL 329. Small Non Cleaved = Burkitt’s: high grade B cell lymphoma. EBV infection. Starry sky histo appearance. T(8;14) c-myc proto-oncogene. Related to B-ALL 330. Benign laryngeal polyps associated w/ smoking & overuse of the voice 331. Associated w/ blebs (large subpleural bullae) that can rupture and cause pneumothorax 332. Obstructed due to bronchogenic carcinoma. Causing swollen face & cyanosis. 333. Associated to oral cancer. 334. Antibodies to parietal cells; pernicious anemia; autoimmune diseases 335. Associated w/ Helicobacter (Campylobacter) pylori infection. 90% of duodenal ulcer 336. Autoimmune origin; middle aged women; anti-mitochondrial Abs 337. Jaundice; itching; hypercholesterolemia (can see cutaneous xanthomas) 338. pancreatic enzymes = fat necrosis; sapponification = hypocalcemia; serum amylase 339. Severe epigastric ab pain; prostration; radiation to the back 340. Chronic pancreatitis 341. No embryo. Paternal derivation only. 46XX 342. Embryo. 2 or more sprems fertilized 1 ovum: triploidy/tetraploidy occurs 343. Hypoplastic Goiter nodules that do not take up radio active iodine. [Opposite: hot & do take up iodine] 344. Mammotrophs = Prolactin 345. Somatotrophs = GH 346. Thyrotrophs = TSH 347. Gonadotrophs = LH 348. Corticotrophs = ACTH & FSH 349. Small/focal aa occlusions. Purely motor or sensory. 350. Sensory: lesion of thalamus 351. Motor: lesion of internal capsule 352. Glucose; Protein; Neutrophils; Pressure 353. Normal Glucose; +/- Protein; Lymphocytes 354. Osteoporosis: Albers-Schonberd Disease = inspite of d bone density, many fractures = osteoclasts 355. Involved in Chemotaxis (for Neutrophils) 356. Involved in Opsonization (& IgG) 357. C3a & C5a (mediate Histamine release from Basophils & Mast cells) 358. Vasoconstriction: TxA2; LTC4; LTD4; LTE4; PAF 359. Vasodilation: PGI2; PGD2; PGE2; PGF2; Bradykinin; PAF 360. d Vascular Permeability: Hist.; 5HT; PGD2; PGE2; PGF2; LTC4; LTD4; LTE4; Bradykinin; PAF 361. ADP; Thrombin; TxA2; collagen; Epinephrine; PAF 362. Prostacyclin (PGI2) 363. F XII (Hagman): APTT 364. F VII: PT Page 8 Lines of Zahn Currant Jelly appearance Emigration: Chemotaxis Transudate Exudate Hurler’s Galactosemia Phenylketonuria Autosomal Dominant Diseases Autosomal Recessive Diseases X Linked Recessive Diseases Hypersensitivity Reactions “ACID” Transplant Rejections Blood Metastasis Lymph Metastasis Aflatoxin Cleft Lip Cleft Palate Craniopharyngioma Lateral Geniculate Nucleus 365. Aterial thrombi = pale red colored (dark red is venous thrombi) 366. Post mortem clots 367. Margination 368. Pavementing 369. Adhesion 370. Chemotaxis 371. Phagocytosis 372. Intracellular microbial killing 373. Specific gravity < 1.012 – low protein 374. Specific gravity > 1.020 – high protein 375. Lysosomal storage disease L Iduronidase – Heparan/Dermatan Sulfate accumulation 376. Deficiency of Galactose 1 Phosphate Uridyl Transferase. Galactose 1 Phosphate 377. Deficiency: Phenylalanine Hydroxylase. Phenyalanine & degradation products 378. Mousy body odor 379. Adult Poly Cystic Kidney Disease 380. Familial Hypercholestrolemia Disease 381. Hereditary Hemorrhagic Telengectasia (Osler-Weber-Rendu) 382. Hereditary Spherocytosis 383. Huntington’s Disease (chromosome 4p) 384. Marfan’s Syndrome 385. Neurofibromatosis (von Recklinghausen’s) 386. Tuberous Sclerosis 387. Von Hippel Lindau Disease 388. Tay-Sachs 389. Gaucher’s 390. Niemann-Pick 391. Hurler’s 392. Von Gierke’s 393. Pompe’s 394. Cori’s 395. McArdle’s 396. Galactosemia 397. PKU 398. Alcaptonuria 399. Hunter’s Syndrome (L-Iduronosulfate Sulfatase deficincy, Heparan/Dermatan Sulfate) 400. Fabry’s Disease ( Galactosidase A deficiency, Ceremide Trihexoside) 401. Classic Hemophilia A (Factor VIII deficiency, F8 Gene on X chromosome is bad, Ceremide Trihexoside) 402. Lisch-Nyhan Syndrome (HGPRT deficiency, Uric acid) 403. G6Phosphatase deficiency (G6PDH deficiency, Ceremide trihexoside) 404. Duchenne’s Muscular Dystrophy (Dystrophin deficinecy, Ceremide Trihexoside) 405. Type I (Anaphylactic): IgE mediated. Exs: Hay Fever; Allergic asthma; Hives 406. Type II (Cytotoxic): Warm Ab autoimmune hemolytic anemia; hemolytic transfusion reactions; Erythroblastosis Fetalis; Grave’s Disease; Goodpastures 407. Type III (Immune Complex): Insoluble complement bound aggregates of Ag-Ab complexes. Exs: Serum sickness; Arthus Reaction; Polyarteritis Nodosa; SLE; Immune Complex Mediated Glomerular Disease 408. Type IV (Delayed = Cell mediated immunity): Delayed hypersensitivity. Involves memory cells. Exs: Tuberculin reaction; Contact dermatitis; Tumor cell killing; Virally infected cell killing 409. Hyperacute Rejection = occurs w/in minutes of transplant. Ab mediated. 410. Acute Rejection = occurs w/in days to months of transplant. Lymphocytes & macrophages. Only rejection type that can be treated w/ therapy. 411. Chronic Rejection = occurs months to years of transplant. Ab mediates vascular damage. 412. Sarcoma, exception – renal cell CA: early venous invasion 413. Carcinoma, exception – renal cell CA: early venous invasion 414. Seen w/ Aspergillus. risk for Hepatocellular CA 415. Incomplete fusion of maxillary prominence w/ median nasal prominence 416. Incomplete fusion of lateral palatine process w/ each other & median nasal prominence & medial palatine prominence 416. Pituitary tumor - usually calcified Inolved in Vision relay Page 9 Medial Geniculate Body Lung Development Heart’s 1st Beat Foregut Midgut Hindgut Hypnagogic Hallucinaitons Type I Error Subdural Hematoma Epidural Hematoma Type II Error Power Sensitivity Specificity Positive Predictive Value Negative Predictive Value Odds Ratio d-Dimers Delusion Loose Association 5 Stages of Death 1st Branchial Arch 2nd Branchial Arch Median nerve lesion Radial nerve lesion Common peroneal lesion Diract inguinal hernia Indirect inguinal hernia @ Diaphragm T8, T10, T12 Hemiballism O Linked Oligosaccharide N Linked Oligosaccharide MLF Syndrome ADA Deficiency Raphe Nucleus waves Irreversible Glycolysis Enzymes Irreversible Gluconeogenesis Enzymes Pellagra Involved in Hearing relay Glandular: 5-17 fetal weeks Canalicular 13-25 fetal weeks Terminal Sac 24 weeks to birth Alveolar period birth-8yoa 21-22 days Mouth Common Bile Duct - supplied by Celiac Artery Duodenum, just below Common Bile Duct Splenic flexure of the Colon supplied by Superior Mesenteric artery Splenic Flexure Butt crack supplied by Inferior Mesenteric Artery Narcolepsy : “Convicting the innocent” – accepting experimental hypothesis/rejecting null hypothesis Ruptured cerebral bridging veins Ruptured middle meningeal artery “intervals of lucidness”, 2ry to Temporal bone fracture : “Setting the guilty free” – fail to reject the null hypotesis when it was false 1- TP/TP + FN TN/TN + FP TP/TP + FP TN/TN + FN ad/bc DIC Disorder of thought content Skip from topic to topic Denial – Anger – Bargaining – Depression – Acceptance Meckel’s cartillage – gives rise to incus/malleus bones of ear Reichert’s cartillage – gives rise to stapes bone of ear No pronation Wrist drop – seen w/ humerus fracture Foot drop. No dorsiflexion or eversion of the foot Goes through superficial inguinal ring. Medial to inferior epigastric artery Seen in older men Goes through deep & superficial inguinal ring Lateral to inferior epigastric artery Seen in young boys – processus vaginalis did not close T8 = Inferior vena cava T10 = Esophagus/ Vagus T12 = Aorta/ Thoracic duct/ Azygous vein Wild flailing of 1 arm. Lesion of the sub thalamic nucleus In the Golgi In the RER Internuclear Ophthalmoplegia: medial rectus palsy on lateral gaze; Nystagmus on abducting eye. Seen w/ MS SCID Initiation of sleep via 5HT predominance Alert; Awake; Active mind – also seen in REM, therefore we say “paradoxical sleep” Hexokinase PhosphoFructo Kinase = Rate Limiting Step Pyruvate Kinase Pyruvate Dehydrogenase PyruvateCarboxy Kinase PEPCarboxyKinase Fructose 1,6 BiPhosphatase Glucose 6 Phosphatase **muscle dose not take part in Gluconeogenesis, only takes place in the liver, kidney & GI epithelium Diarrhea, Dermatitis, Dementia Page 10 TLCFN LCAT or PCAT HMGCoA Reductase Ketogenic amino acids Glucogenic amino acids Keto & Gluco amino acids Carnitine Shuttle Cori Cycle (-) Na+ Pump (ATPase) TCA Cycle Products Cones Rods Gastrula Epiblast Sydenham’s Chorea (+) Frei Test Sabouraud’s Agar FMR1 Gene Defect Barr Body Aortic Insufficiency Signs Scleroderma :”CREST” Cretinism Hemochromatosis Triad Niacin Deficiency (Vit B3 deficiency) Hartnup’s Disease Malignant Carcinoid Syndrome INH use Needed as co-factor for Pyruvate DH complex & Ketoglutarate DH complex Esterification of cholesterol: lecithin cholesterol acetyltransferase Lecithin = Phosphatidylcholine, therefore phosphotidylcholine acetyltransferase Rate limiting step in cholesterol synthesis Changes HMGCoA Mevalonate (-) by Lovastatin Leucine & Lysine Methionine, Threonine, Valine, Arginine, Histadine Phenylalanine, Trytophan, Isoleucine Feeds FA into the mitochondria for their consumption Keeps muscles working anaerobically. Transfers lactate to the liver to make glucose which is sent back into the muscles for energy use Ouabain [(-) K+ pump] Vanadate [(-) phosphorylation] Digoxin [ heart contractility] “Citric Acid Is Krebs Starting Substrate For Mitochondrial Oxidation” Citrate Aconitate Isocitrate Ketoglutarate Succinyl Succinate Fumarate Malate OAA Color vision. Contain Iodopsin = Red-Blue-Green specific pigment. For acuity. Contain Rhodopsin pigment. High sensitivity. Concentrated in the fovea. Night vision. Seen @ 3rd week: Ecto, Meso & Endo @ 2nd week: forms the primitive streak, from which Meso & Endo come from. Directly gives rise to Ecto. Post streptococcal infection. Necrotizing arteritis of the caudate, putamen, thalamus Chlamydia trachomatis types L1, L2, L3 = Lymphogranuloma venereum Culture for all Fungi ie…Culture Cryptococcus neofromans which is found in pigeon droppings Fragile X Syndrome: macro-orchidism; long face; large jaw; large everted ears; autism, mental retardation Present in Kleinfelters: Male: XXY Not present in Turner’s: Female: XO Traube Sign = Pistol shot sound over the femoral vessels Corrigan pulse = water hammer pulse over coratid artery = aortic regurgitation Calcinosis; Raynauds; Esophageal; Sclerodactyl; Telangiectasis Sporadic: bad T4 phosphorylation or developmental failure of thyroid formation Endemic: no Iodine in diet: protruding belly & belly button Micronodular pigment cirrhosis; Bronze Diabetes; Skin pigmentation = due to Fe3+ deposition Signature Drug Toxicities Agranulocytosis Aplastic Anemia 417. Clozapine, Chloramphenical 418. 419. 420. Chloramphenicol NSAIDs Benzene Atropine-like Side Effects Cardiotoxicity 421. Tricyclics 422. 423. Doxorubicin Daunorubicin Cartilage Damage in Children Cinchonism Cough Nephrogenic Diabetes Insipidus Disulfiram-like Effect 424. Fluoroquinolones (Ciprofloxacin & Norfloxacin) 425. Quinidine 426. ACE Inhibitors 427. Lithium (Txt w/ Amiloride) 428. 429. Metronidazole Sulfonylureas (1st generation) Extrapyramidal Side Effects Fanconi’s Syndrome Fatal Hepatotoxicity (necrosis) 430. Antipsychotics 431. Tetracycline 432. Valproic Acid (Thioridazine, Haloperidol, Chlorpromazine) Page 11 433. 434. Halothane Acetaminophen Gingival Hyperplasia Gray Baby Syndrome Gynecomastia 435. Phenytoin 436. Chloramphenicol 437. 438. 439. 440. Cimetidine Azoles Spironolactone Digitalis Hemolytic Anemia in G6PD-deficiency 441. 442. 443. 444. 445. Sulfonamides Isoniazid Aspirin Ibuprofen Primaquine Hepatitis Hot Flashes, Flushing 446. Isoniazid 447. 448. 449. Niacin Tamoxifen Ca++ Channel Blockers Induce CP450 450. 451. 452. 453. Barbiturates – Phenobarbital Phenytoin Carbamazepine Rifampin Inhibit CP450 454. 455. Cimetidine Ketoconazole Interstitial Nephritis 456. 457. 458. 459. Methicillin NSAIDs (except Aspirin) Furosemide Sulfonamides Monday Disease 460. Nitroglycerin Orange Body Fluids Osteoporosis 461. Rifampin 462. 463. Heparin Corticosteroids Positive Coombs’ Test Pulmonary Fibrosis 464. Methyldopa 465. 466. Bleomycin Amiodarone Red Man Syndrome Severe HTN with Tyramine SLE-like Syndrome 467. Vancomycin 468. MAOIs 469. 470. 471. Procainamide Hydralazine INH Tardive Dyskinesia 472. 473. Antipsychotics (Thioridazine, Haloperidol, Chlorpromazine) Clozapine: only antipsychotic to not give you tardive dyskinesia Tinnitus 474. 475. Aspirin Quinidine Industrial exposure tolerance during week loss of tolerance during weekend headache, - ach, dizziness upon re-exposure Micro Lactose formers Non lactose formers May lack color 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. “CEEK” Citrobacter Enterobacter E.Coli (K1 capsule most important) Klebsiella “SHYPS” Shigella Yersinia enterolytica (AKA Pestis) Proteus Salmonella “These rascals may microscopically lack color”: Treponema Ricksetta Mycobacterium Page 12 Motile: make H2S Non Motile: noH2S cAMP Have Capsules [ie… are Quellung Reaction (+)] Dimorphic Fungi Have Prophage Spore Forming Bacteria IgA Proteases Widal Test Wayson’s Stain Pneumonic Plaque Transmission Splenectomy Invasins Fusiform S. viridans Obligate Aerobes Obligate Anaerobes Staph aureus Spirochetes Non Motile Gram (+) Rods Acid Fast Organisms Pigment Producing Bacteria Bacterial Morphology Inclusion Bodies Schistosoma Japonicum Monsoni 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. 41. Mycoplasma Legionella Chlamydia “CAPE” Cholera Anthracis (Poly D glutamate capsule) Pertusis (via Gi) E.coli (LT enterotoxin) “Some killers have pretty nice capsules” Strep. Pneumoniae Klebsiella HiB Pseudamona Aeroginosa Neisseria meningitis Cryptococcus neoformans (only encapsulated fungal pathogen) “Can Also Have Both Shapes” Cocciodes Aspergillus Histolpasma Blastomyces Sprothrix schenkii “OBED” O = Salmonella B = Botulinum E = Erythrogenic strep D = Diptheria Bacilus & Clostridium (have calcium di-picolinate) 42. Neisseria, Haemophilus, S. pneumoniae 43. Salmonella (Salmonella begins in the ileocecal region) agglutination indicates Abs to O, H, Vi Salmunella Ags 44. Yersinia 45. Person to person cf w/ Bubonic plaque that was via infected flea 46. Predisposes to septicemia 47. Yersinia pseudotuberculosis 48. Vincent’s trench mouth 49. Dextran mediated adherence 50. Pseudomonas & Mycobacterium 51. Clostridium, Actinomyces, Bacteroides 52. A Protein, Catalase +/ Coagulase + 53. Treponema, Borrelia, Leptospira 54. Corenybacterium D & Nocardia 55. Mycobacterium; Cryptosporidium; Nocardia (partially); Legionella micdadei; Isospora 56. 57. 58. 59. 60. 61. 62. 63. 64. 65. 66. 67. 68. 69. 70. 71. 72. 73. Serratia – red (can cause pseudohemoptysis) Pseudomonas A – piocyanin blue/green Staph Aureus – yellow – Protein A Mycobacteria – photo/scoto chromogenic – caritinoid – yellow/orange Corneybacterium D – black/gray – pseudomembrane plaque in throat Bacteroides (Porphyromonas) melaninogenicus – black (heme) E. coli – irredescent green sheen Pneumococci – lancet shaped diplococci Neisseria – kidney bean shaped diplococci Camphylobacter – gulls’ wings/comas Vibrio Cholera – coma shaped Corneybacterium D – club shaped (nonmotile, G+Rod) Yersinia – safety pin seen in Wayson’s stain Rabies – Negri bodies – intracytoplasmic Pox virus – Guarnieri – intracytoplasmic & acidophilic CMV – Owl’s eyes – intracytoplasmic & intranuclear HSV – Cowdry bodies – intranuclear Intestinal – contact w/ bad water Page 13 Schistosoma Haematolium Non Human Schistosom Clonorchichis Fasciola Hepatica Fasciola Biski Paragonimus Westermani Oxidase (+) Micro Aerophilic Urease (+) Coagulase (+) Obligate Intracellular Bacteria Protozoa Obligate Non Intracellular Parasites Haemophilus Factors All cocci are “Eaton Fried Eggs” Mycoplasma Sabrands Malassazia furfur Measles’ 3C’s Non Motile Bacilli & Clostridium Bloody diarrhea agents YW-135CA Indian Ink Naegleria causes Need Cysyeine for growth Endotoxins, G(+) or G(-) Ecthyma Gangrenosum, seen w/ Endospores G(+) Multi Brain Abscess Single Brain Abscess risk for Strep pneum Infection Hemolysis/Optochin Sensitive Hemolysis/Optochin Resistant Staph. Saprophyticus Staph. Epidermidis Hemolysis/Bacitracin Sensitive Hemolysis/Bacitracin Resistant EFII Ribosylation Bacillus Anthracis: 3 toxins 74. Vesicular – contact w/ bad water 75. Swimmer’s itch – contact w/ bad water 76. Chinese liver fluke – eating raw fish. Txt: Praziquantel 77. Sheep – eating raw fish. Txt: Praziquantel 78. Giant intestinal flukes – eating raw fish. Txt: Praziquantel 79. Lung fluke – eating raw fish. Txt: Praziquantel 80. Neiserria and most Gram (-)s 81. Camphylobacter & Helicobacter 82. 83. 84. 85. 86. 87. All Proteus – can cause Staghorn/Struvite calculi (NH4- Mg2- stones): alkaline urine Ureaplasma Campylobacter pylori (Helicobacter) Cryptococcus Nocardia Staph A & Yersenia pestis 88. Chlamydia Pistacci (Chlamydia do not make own ATP); Mycobacterium Leprae; all Rickettsia except Roachalimea (make suficient ATP to survive) 89. Plasmodium; Toxoplasma ghondi; Babesin; Leishmania; Trypanosoma Cruzi 90. Treponema palidum & Pneumocystis Carinii (cannot be cultured on inert media but can be found extra cellularly in the body) 91. X = Protoporphyrin & V = NAD 92. Gram (+) except for Neisseria & Moraxella 93. Mycoplasma pneumoniae has fried egg colonies on Eaton agar (needs cholesterol) 94. 95. 96. 97. 98. No cell wall. Membrane has cholesterol. Smallest living bacteria. P1 protein inhs ciliary action Fried egg colonies Atypical pneumonia – young adults Fungal media 99. Spaghetti & meat ball 100. Cough – Coryza – Conjunctivitis. Can also have photophobia 101. May lead to subacute Sclerosing Panencephalitis 102. B. Anthracis & C. Perfringens 103. EIEC – EHEC – Shigella - Yersenia enterocolitica – Entaemeba histolytica – Salmonella – Campylobacter jejuni 104. N. meningitidis vaccine capsualr polysaccharide strains 105. Cryptococcus neoformans 106. Colonization in the nasal passages after swimming 107. 108. 109. 110. 111. 112. “Ella likes cysteine”: Francisella Brucella Legionella Pasturella Gram (-): N. meningitidis 113. Pseudomonas aeroginosa. Target shaped skin lesions w/ a black center and red ring surrounding the lesion 114. Gram (+): Bacillus & Clostridium – made up of dipicolinate & Keratin 115. Nocardia 116. Actinomyces israelli 117. Asplenic; Sickle cell anemia; immunocompromising illness 118. Strep. Pneumoniae 119. Strep. Viridans (Subacute Endocarditis) 120. Novobiocin Resistant (UTIs) 121. Novobiocin sensitive (Endocarditis in IVDUs) 122. Strep. Pyogenes (pharyngitis; Scarlet fever; cellulitis; impetigo; Rheumatic fever)) 123. Hyaluronic capsule; non-motile; M proteins; Endotoxin A 124. Strep. Agalactiae (Diabetes predisposes to infection) 125. Diphtheria toxin & Pseudomonas exotoxon A 126. Protective Antigen (PA) Page 14 (work via adenylate cyclase) Woolsorter’s Disease Grows in Rice Clostridium Perfringens Clostridium Difficile Spastic Paralysis toxin Clostridium Botulinum Infant Botulinum Thayer Martin Agar DOC for N. gonorrhoeae K1 E. Coli Capsular Ag The A’s of Klebsiella Rice H2O Diarrhea Raw seafood intoxicaiton Helicobacter Txt risk of P. aeroginosa infection Contact lens’ infection Cat Bites Undulant Fever Bordet Gengou Agar Lowenstein-Jensen medium Cat Scratch Disease Pink Eye True Hemaphrodite Pseudo Hemaphrodite Male Pseudo Hemaphrodite HLA Genes Location Parvovirus B19 Interferon MOA Acute Hemorrhagic Conjunctivitis Parainfluenza Causes… Swimming Pool Conjunctivitis RSV Removed tonsils, find what virus Bone Fever HbsAg HbeAg Anti-Hbc Filamentous Bacteria Listeria contaminates Shiga like Toxin Necrotizing Fasciitis Relapsing Fever Loffler’s Medium Chlamydiae Developmental Cycle 127. Lethal Factor = toxic to macrophages 128. Edema Factor = cAMP 129. Bacillus anthracis. DOC: Penicillin 130. Bacillus Cereus 131. 132. 133. 134. 135. 136. Double Zone Hemolysis (test) Lecithinase: toxin = lyses RBCs 80% of gas gangrene (myonecrosis) cases 2 Toxins: Enterotoxin (Exotoxin A) & Cytotoxin (Exotoxin B) Pseudomembranous colitis (can be precipitated by clindamycin/ampicillin) Clostridium Tetani toxin 137. Bad canned foods have neurotoxin = flaccid paralysis (block Ach release) 138. Floppy Baby Syndrome. Pre formed toxin in honey 139. Neisseria ID 140. Ceftriazone 141. Related w/ neonateal meningitis 142. 143. 144. 145. Alcoholics Aspiration pneumonia Abscesses in the lungs Vibrio Cholera: metabolic acidosis 146. Vibrio parahemolyticus 147. Bismuth salts; Metronidazole; Tetracycline (or amoxicillin) 148. Burn patients & Cystic fibrosis 149. Pseudomonas aeroginosa 150. Pasteurella multocida 151. Brucella 152. Bordetella pertusis ID 153. M. tuberculosis ID 154. Bartonella henselae. Leion can resemble Kaposi’s sarcoma. 155. Toxoplasmosis 156. Adenovirus (type 8) 157. Testes & Ovaries are present 158. External genitalia does not coincide w/ gonads 159. Testicular Feminization 160. 6p 161. Fifth Disease: Erythema Infectiosum (ssDNA). Linked w/ sicle cell anemia 162. Inhibits viral replication (translation or transcription) 163. Seen w/ infections from Enterovirus & Coxsackie A 164. Croup (Laryngotracheobronchitis) 165. Adenovirus (types 3 & 4) 166. Bronchiolitis in infants 167. In 80%, Adenovirus. In the immunosuppressed, activation can occur 168. Dengue: Group B Togavirus, from the Arbovirus, transmitted by mosquitos 169. 170. 171. 172. 173. 174. 175. Appears in blood soon after infection, before onset of acute illness Disappears w/in 4-6 months after the start of clinical illness Appears early acute phase, indicates higher risk of transmitting the disease Disappears before HbsAg is gone Present in beginning of clinical illness Seen in the “window phase” Actinomycetes = Nocardia; Actinomyces; Streptomyces 176. Milk, cheese, vegetables (coleslaw) in recent infections 177. E. Coli 0157/H7: Hemorrhagic colitis & Hemorrhagic uremic syndrome 178. Group A Streptococci 179. Borrelia recurrentis 180. Corneybacterium diphtheriae 181. Elementary Body: infeccious particle that Enters the cell 182. Reticulate Body: made from elementary body. Replicates, differentiates and Page 15 Trench Fever “Spotted Fever” Members Thrush Txt Rose Bush Thorns Contact lens solution infection Filiariasis Causant Freshwater lake infection Reduviid bug bite Schistosoma Haematobium causes Schistosoma Mansoni causes Snail, intermediate host of… Ixodes scapularis transmits Nantucket Protozoa Infection by Reduviid Bug Infection by TseTse Fly Infection by Sandfly Infection by Ixodes Tick Infection by Anopheles Mosquito Trophozoites w/ “Face-Like” Appearance Nonseptate Hyphae Histoplasmosis Geography Coocidioidomycosis Geography Blastomycosis Geography Paracoccidioidomycosis Geography Roseola Infection, aka Herpangina Orthomyxovirus Paramyxovirus Togavirus Flaviviris Bunyavirus IgA Protease Activity Diphtheria: ABCDEFG releases elementary bodies to infect other cells 183. W/ infection you will see Glycogen containing inclusions 184. Cell wall lacks muramic acid 185. Rochalimaea quintana 186. Rickettssia rickettsii (RMSF) & R. akari (rickettsial pox) in the U.S. 187. R. sibirica (tick typhus in China) & R. australis (typhus in Australia) 188. Nystatin txts candidiasis of the mouth 189. Have Sporothrix schenckii 190. Acanthamoeba 191. Wucheria bancrofti (infection aka elephantitis & wucheriasis 192. Causes amebic meningoencephalitis due to Naegleria fowleri 193. Transmits Trypanoma cruzi (Chagas’ disease): Romana’s Sign 194. Bladder calcificaiton & cancer 195. Presinusoidal HTN, splenomagaly, esophageal varices 196. Schistosomiasis 197. Babesia (clinically rembles malaria) & Borelia burgdorferi 198. Babesia microt 199. Trypansoma cruzi: Chagas’ Disease 200. Trypansoma brucei gambiense & rhodiense: African Sleeping Sickness 201. Leishmaniasis: Mucocutaneous Diseases by L. braziliensis & Visceral Disease by L. donovani & Dermal Leishman by L. tropica, mexicana, peruviana 202. Babesia microti: Babesiosis & Borrelia burgdorferi: Lyme Disease 203. Malaria 204. Giardia lamblia 205. Zygomycosis: Rhizopus & Mucor. Only mycosis w/o septate. Infect Ketoacidotic Diabetics. 206. Ohio, Mississippi, Misouri River valleys 207. Southwestern deserts, California 208. States east of Mississippi River 209. Latin America 210. Exanthema Subitum: “Sixth Disease” (Human Herpes Virus-6 dsDNA, enveloped) 211. “Hand-Foot-and-Mouth” Disease: Coxsackie A (Picornavirus +ssRNA) 212. –ssRNA, enveloped virus. 213. Spike Glycoproteins (peplomeres): HA = Hemagluttinin & NA = Neuraminidase. These peplomeres are what give the virus antigenis variation 214. Influenza A & B 215. –RNA, enveloped. Most common cause of respiratory infections in kids 216. Mumps 217. Croup(Parainfluenza virus) 218. Rubeola(Measles virus) 219. RSV 220. +ssRNA, enveloped 221. 3 Day Measles: German Measles: Rubella/ Rubivirus 222. Encephalitis viruses: Alphaviruses: Eastern (more severe) and Western Equine Encephalitis 223. Dengue Fever – icterus & hemorrhage w/ blac vomit 224. Yellow fever 225. St. Louis Encephalitis – no hepatitis or hemorrhage 226. –ssRNA, enveloped 227. California Encephalitis – severe bifrontal headaches 228. Hantavirus – hemorrhagic fever w/ acute resp. distress syndrome 229. H. Influenzae (needs factors V & X for growth) 230. Strep. Pneumoniae 231. N. meningitidis 232. N. gonnorhoae 233. W/ this activity these bugs are able to colonize the oral mucosa. 234. Adenopathy 235. Prophage encodes the exotoxin 236. Corneybacteria is Club shaped Page 16 237. Diphtheria 238. Elongation Factor II 239. Granules (metachromatic) 240. Parvovirus: “Part of a virus” Only ssDNA Only dsRNA Naked RNA 2 circular DNAs BK Hepadna, Retrovirus? Picornovirus: “PERCH” Hemorrhagic Fevers Segmented viruses Eclipse Phase Latent Phase Naked Capsid Virus Enveloped Virus Interferon 241. Reovirus, “RepeatOvirus” 242. “Naked for CPR”: Calcivirus; Picornovirus; Reovirus 243. Papovavirus & Hepadnavirus 244. Papovavirus. Seen in kidney transplant patients (causes renal disease) 245. No, but has reverse transcriptase 246. Poiliovirus; Echo; Rhino; Coxsackie; Hep A 221. Filovirus & Bunyavirus (Hantavirus) All are RNA: Orthomyxo; Arena; Bunya; Reo No internal virus. 1 total virus per cell No external virus. Extracellular virus found Nucleocapsid. DNA or RNA + Structural proteins Membrane. Nucleocapsid + Glycoprotein AIDS structural prots AIDS regulatory prots AIDS gp41 env prot AIDS gp120 env prot AIDS p17 gag prot AIDS p24 gag prot AIDS p7p9 gag prot DNA Viruses Non virus specific. Works by RNA endonuclease = digests viral DNA + inh viral prot synth Gag, pol, env Tat, rev, nef Transmembrane Surface Matrix Capsid Nucleocapsid A = Adeno H = Herpes H= Hepadna P = Pox P = Parvo P = Papova E Brick. Rep In Cyto AH H PPP --- ico Rep in Nuc SS Circ (+) RNA Viruses E C P R F T C ------ ico (+) Linear. No segment. Rep in Cyto Helical R-Tase & Rep in Nuc (-) RNA Viruses 8 2 3 F O R P A B ---- (-) E Helical Linear. Non seg. C = Calici P = Picorno R = Reo F = Flavi T = Toga C = Corona F = Filo O = Orthomyxo R = Rhabdo P = Paramyxo A = Arena B = Bunya Bullet Anti sense Hepatitis Window Period Hepatitis Downey Type II cells A Picorna After HbsAg disappears & Before HbsAb appears B Hepadna EBV C Flavi Page 17 D Delta E Calici Infection by Aedes Mosquito “Hot T-Bone stEAk”: ILs Yellow Fever: Flavivirus: Black vomit, jaundice, high fever IL1 = Temp: HOT IL2 = stimulate T cells IL3 = stimulate Bone Marrow stem cells’ growth & differentiation (GM CSF) IL4 = stimulate IgE (& IgG) IL5 = stimulate IgA (& eosinophils) IL2, IL4, IL5, IFN gamma ILs Secreted by CD4s ILs Secreted by Macrophages C5a IL1 & TNF Neutral chemotaxis. When it is w/ C3a, participates in anaphylaxis When both Alternative and Classic pathways come together Alternative: C3b, Bb, C3b + C3a C5 Classic: 2b, 3b, C3a + C4b C5 Quintana C5 Convertase Only Richettssia not Intracellular Plasmodium Life Cycle Sporozoites: from blood to liver Primary tissue schizont Trophozoites: in RBC Erythrocytic schizont Merozoite: ruptured RBC Gametozyte Zygote: inside the mosquito Acanthamoeba Mucor, Rhizopus, Absidia Cryptococcus Neoformans Candida Aspergillus Fumigatum Cocciodes Histoplasma Cap Star shaped cysts Nonseptate, filamentous, 90 degree branching, indian in, capsular halos Monomorphic Yeast normally, pseudo & true hyphae in tissue infections 45 degree branching point, asoc’d w/ cystic fibrosis & burns pt Hyphae in wild. Artroconidia. Arthocondida & Hyphae. Sherules w/ endospores Hyphae in wild. Microcondida w/ tuberculate macrocondida. Fac intracellular. In the tissue it’s a yeast w/ a small neck. Hyphae in wild Blastomycosis Sporothrix Schenkii PCP Gram (-) Bugs w/ Exotoxins Hypahe in wild. Potas iodide in milk. Pneumonia in alcoholics. Obligate parasite. Kills type I pneumo cells. Ground glass E. Coli; V. Cholera; Bordetella Pertussis Dermatophytes Fever Trichophyton: SHN Microsporium: SH Epidermophyton: SN Tinea tavus: permanent hair loss Diagnosis Trophozoites or cysts in stool Trophozoites or cysts in stool Acid fast oocysts Trophozoites or cysts in stool Motile trophozoites Fever Spike Vivax Benign 3 degrees 48h Enlarged Host Cell Ovale Benign 3 degrees 48h Oval/Jagged Malariae 4 degrees of Malarial 72hrregular Crescent Falciparum Malignant 3 degrees Transmission Cysts Cysts Cysts Cysts Trophozoites E. Histolitica Giardia Cryptosporidium Balantium C. Trichomonas V. Miscellaneous 1. Fastest growing tumor – Burkitt’s 2. PE’s are found in half of all autopsies 3. Courvoisier’s Law: tumors that obstruct the common bile duct cause enlarged gallbladders, but obstructing gallstones do not (too much scarring), so if you can palpate the gallbladder you’e probably looking at cancer. 4. Only DNA virus to replicate in cytoplasm: Pox 5. Only RNA virus to replicate in nucleus: Influenza Page 18 6. 7. 8. 9. Bacillus anthracis has the only protein capsule Bordetella pertussis (Whooping Cough) elicits lymphocytosis rather than granulocytosis Bronchioalveolar carcinomas grow without destroying the normal architecture of the lung Cryptococcus neoformans often lacks a capsule and, when stained with GMS, looks just like Pneumycistis carinii, except that Cryptococcus lacks the prominent nucleoli. 10. Weil Felix reaction: (+)R. rickettssi & (+)Proteus vulgaris & P. mirabilis 11. Treponema pallidum (Syphilis) tests: 1)VDRL 2)FTA-Abs: most widely used 3)TPI (immobilization test – most expensive but the Gold Standard) Cytokine Source Function IL 1 12. Monocytes, macrophages Stimulates T cell proliferation & IL2 produciton IL 2 13. Macrophages, T & NK cells Stim prolif of B, T & NK cell IL 3 14. T cells GF of tissue mast cells & hematopoietic stem cells IL 4 15. T cells growth of B & T cells/ HLA II Ags IL 5 16. T cells Maturation of B plasma cell IL 6 17. T cells, monocytes Maturation of B & T cell/ (-) fibroblasts IFN 18. B cells, macrophages Antiviral activity IFN 19. Fibroblasts Antiviral activity IFN gamma 20. T & NK cells Antiviral activity, (+) macrophages, HLA II Ags TNF 21. Macrophages, T & NK cells T cell prolif, IL 2 prod, cytotoxicity TNF 22. T cells T cell prolif, IL 2 prod, cytotoxicity Tumor Suppressor Genes Genes VHL APC WT-1 Rb BRCA-2 p53 NF-1 BRCA-1 DCC DPC NF-2 Chrom. 3p 5p 11p 13q 13q 17p 17q 17q 18q 18q 22q Associated Tumors Von Hippel Lindau, Renal Cell CA Familial adenomatous polyposis, Colon CA Wilm’s tumor Retinoblastoma, Osteosarcoma Breast CA Most human Cas Neurofibromatosis type 1 Breast CA, Ovarian CA Colon & Stomach CA Pancreatic CA Neurofibromatosis type 2 = bilateral acoustic neuroma Physio Equations: Resistance in Series: Add all Resistance in Parallel: Invert the answer RENAL: Filtration Fraction = GFR RPF Filtered Load = GFR x [Conc] GFR: Glomerular Filtration Rate RPF: Renal Plasma Flow Excretion Rate = [Urine] x VelUrine Page 19 Clearance = [Urine]xVel(Urine) Excretion or [ Plasma ] [Plasma ] Renal Blood Flow = ERPF 1 Hct Clearance of PAH = [ERPF] Free Water Clearance = VelUrine - ERPF: Eff renal plasma flow Urine(osm) xVel(urine ) P(osm) CARDIO: CO = HR x SV CO = O 2(consumed ) PulmonaryA VO2difference MAP = Diastolic + 1/3 Pulse Pressure CO = MAP TPR Pulse Pressure = Systolic – Diastolic MAP = TPR x CO F= P1 P 2 R LUNGS: PAO2 = (760 – 47) FO2 - PACO2 R Where: FO2 = [O2] Flow = PACO2 = Alv. Press. Of CO2 O2consumed AtoVO2difference Velgas Diffusion = VentTot = VentTidal x #of Respirations Compliance = Vol Pr ess P= R = Resp. Exchange Ratio Tension Radius Resp Doubles: 150mmHg & 40mmHg CO 2 produced .8 or 1 O 2consumed Area x Gas Diffusion Constant x Difference of Partial Press Thickness VentAlv = (VentTidal – VentDead) x # of Respirations 1.0 = Va/Q New PCO2 = 20 Diffusing Capacity = New PO2 = 170 Page 20 COuptake PACO2