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Pass Program Clues

<RXDLQWWROGPHVTXDWWLOO\RX
WHOOPHWKH&/8(

What are the 5 bacteria causing


Heart Block?
Lyme Disease
Salmonella typhii (typhoid)
&KDJDV'LVHDVH :KLSSOHV
Legionella
Diptheria
Lets Stop Doing Long Contractions

:KDWEDFWHULDFDXVH5HLWHUV
Syndrome?
Shigella
IBD
&URKQV

Chlamydia
Yersina
Reiter & Crohn Saw Yersina and got
Chlamyia

What are the Low Complement


bugs causing Cryoglobuniemia?
Influenzae
Adenovirus
Mycoplasma
Hepatitis C
EBV
I AM HE

What are the drugs induced


SLE?

Hydralazine
INH
Phenytoin
Procainamide
Penicillamine
Ethosuximide

H I PPPE

What are the drugs that Blast


the BM?
AZT
Benzene
Chloramphenicol
Vinblastine
Vinblastine Anilate Bone Cells

What are the Comma Shaped


bugs?
Vibrio
Campylobacter
Listeria
H. pylori
Campylobacter Has Very Long Comma
Genes

What is the cresent shaped


protozoa?
Giardia lamblia

What bacteria looks like Chinese


letters?
Corynebacter

What are the TB Rx?


Rifampin
Pyrazinamide
INH
Ethambutanol
Streptomycin
R E S P I

What are the 6 Low Complement


assocs. with Nephrotic Syndrome?

Serum Sickness
PSGN
SLE
SBE
Cryoglobinemia
MPGN II

What drugs Induce p450?


BAG 4 CPR QTS
Barbiturates
Car Grabs Queens Tets to Alcohol
Rev Up
Alcoholic doing drugs and Griseofulvin
Carbamazapine
stinking up car
Rifampin
Quinidine
Tetracycline
Sulfa drugs

What drugs Inhibit p450?


I Do SMACK
Quinolones

INH
Dapsone
Spirolactones
Macrolides
Amiodarone
Cimetidine
Ketoconazole
Quinilones

What drugs are P450


Dependent?

Warfarin
Estrogen
Phenytoin
Theophylline
Digoxin

Theo came from war & dig inside WDEPT taking


Estrogen & now is Phenytoin

What disease is a Neutophil


Deficiency?
CGD

What is another name for CGD?


Chronic Granulomatous disease
NADPH Oxidase deficiency

What are the Side effects of


Statins?
Myositis
Hepatitis
Increased liver enzymes

What are the painful genital


Lesions?
Chancroid
Herpes
Lymphogranuloma inguinale

What is the painful chancroid


lesion due to?
Hemophilus ducreyi

What are the 4 hormones with


disulfide bonds?
Prolactin
Insulin
Inhibin
GH
I PIG on BONDS

What are the Hookworms?

Necatur americanis
Enterobius vermicularis
Ankylostoma duodenale
Trichuris trichurium
Ascaris lumbercoides
Strongyloides

Hooks AS NEAT

What diseases do we screen for


at birth?

Please
Check
Before
Going
Home

PKU
CAH(Congential

Adrenal Hyperplasia)
Biotinidase
Galactosemia
Hypothyroidism

HLA-Antigens
HLA-DR2= 1DUFROHSV\$OOHUJ\*RRGSDVWXUHV

MS
HLA-DR3= DM, Chronic Active Hepatitis,
6MRJUHQV6/(&HOLDF6SUXH
HLA-DR3 & 4= IDDM(Type I)
HLA-DR4= Rheumatoid Arthritis, Pemphigus
Vulgaris
HLA-DR5= JRA, Pernicious Anemia
HLA-DR7= Nephrotic Syndrome(Steroid induced)

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
6SRQG\OLWLV,%'5HLWHUV3RVWJRQRFRFFDO
Arthritis
HLA-BW 47= 21 alpha Hydroxylas def.(Vit.D)

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

What are the causes of


Monocytosis?
Salmonella (typhoid)
TB
EBV
Listeria
Syphillis

E. Coli is the most common


cause of what?
UTI
Spontaneous bacterial peritonitis
Abdominal abscess
Cholecystitis
Ascending cholangitis
Appendicitis

What are the one dose treatments


for Gonorrhea?
Ceftriaxone
Cefixime
Cefoxine
Ciprofloxin
Oflaxacin
Gatifolxacin

What is the one dose treatment for


Chlamydia?
Azithromycin

:KDWDUHWKH%LJ0DPD
anaerobes?
Strep bovis
Clostridium melanogosepticus
Bacteriodes fragilis

:KDWDUHWKH%LJ0DPD5["
Clindamycin
Metranidazole
Cefoxitin

:KDWELJPDPDEXJVDUH
associated with colon cancer?
Strep. Bovis
Clostridium melanogosepticus

What do you see in the serum with


low volume state?
K+?
Decreases
Na+?
Decreases
Cl-?
Decreases
pH?
Increases

BP?
Increases

What are psammoma bodies?


&DOFLILHG&$V

In what diseases are Psammoa


Bodies present?
Papillary carcinoma of the Thyroid
Serous cystadenocarcinoma of the ovary
Meningioma
Mesothelioma

What are the Urease (+)


Bacteria?
Proteus
Pseudomonas
Ureaplasma urealyticum
Nocardia species
Cryptococcus neoformans
H. pylori

What types of stones are


formed from Proteus?
Struvite (90%)

What type of motility do Proteus


have?
swarming

What are 5 indications of


Surgery?
Intractable pain
Hemorrhage (massive)
Obstruction (from scarring)
Perforation

What drugs cause Cardiac


Fibrosis?
Adriamycin (Doxyrubicin)
Phen-fen

What drug is used to tx cardiac


fibrosis?
Dozaroxsin

What is the MCC of any


SHQLD"
#1 = Virus
#2 = Drugs

What is seen in the Salmonella


Triad?
High Fever
Rose spots (rash)
Intestinal fire

What drugs cause Myositis?


Rifampin
INH
Predinsone
Statins

What are the 7 Gram -


encapsulated bacteria?

Some
Strange
Killers
Have
Pretty
Nice
Capsules

Salmonella
Strep. Pneumo (gr+)
Klebsiella
H. influenza
Pseudomonas
Neisseria
Cryptococcus

What is the Jones Criteria for


Rheumatic Fever?
SubQ nodules
Polyarthritis
Erythema marginatum
Carditis
Chorea

What are the causes of


Eosinophilla?
Neoplasms
Allergies/Asthma
$GGLVRQV']
Collagen Vascular Dz
Parasites

What are the Risk Factors for


Liver CA?

Hep B,C,D
Aflatoxin
Vinyl chloride
Ethanol
Carbon Tetrachloride
Anyline Dyes
Smoking
Hemochromatosis
Benzene
Schistomiasis

What are the 9 Live Vaccines?

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

What are the Killed Vaccines?


SIR Hep A

Salk (polio)
Influenza
Rubella
Hepatitis A

What are the IgA


Nephropathies?
Henoch-Schoenlein P. (HSP)
$OSRUWV
%HUJHUV

What are the Drugs that cause


Autoimmune hemolytic anemia?

PCN
-methyldopa
Cephalosporins
Sulfa
PTU
Anti-malarials
Dapsone

What are the drugs that cause


Autoimmune thrombocytopenia?
ASA
Heparin
Quinidine

What are the enzymes that show


after an MI?
Troponin I
CKMB
LDH

What is the first MI enzyme to


appear?

Troponin I
Appears
Peaks
Gone

2 hrs
2 days
7 days

nd
What is the 2

appear?

CK-MB
Appears
Peaks
Gone

MI enzyme to

6 hrs
12 hrs
24 hrs

rd
What is the 3

appear?

LDH
Appears
Peaks
Gone

MI enzyme to

1 day
2 days
3 days

What bacteria have Silver Stains?


Legionella
Pneumocysitis carinii
H. pylori
Bartonella henseslae (lymph node)
Candida (yeast)

What are the sulfa containing


drugs?
Sulfonamides
Sulfonylurea
Celebrex

What is another name for celebrex?


Celecoxib

What type of inhibitor is Celebrex?


COX 2 specific

What COX-2 specific drug can you


give to a pt with sulfa allergy?
Vioxx (Rofecoxib)

What drugs inhibit dihydrofolate


reductase?
Pyremethamin/Sulfadiazine
Trimethoprim/Sulfamethoxazole

What drugs cause Pulmonary


Fibrosis?
Bleomycin
Bulsufan
Amiodarone
Tocainide

What are the macrophage


deficiency diseases?
Chediak-Higashi
NADPH-oxidase deficiency

What are the SE of Loops and


Thiazides?
Hyperglycemia
Hyperuricemia
Hypovolemia
Hypokalemia

What are the SE of Loop diuretics?


OH DANG

Ototoxicity
Hypokalemia
Dehydration
Allergy
Nephritis (interstitial)
Gout

What are the only 3 Pansystolic


Murmurs and when are they heard?
MR

Decrease on

TR

VSD

inspiration (^exp)
Increase on
inspiration
Decrease on
inspiration (^exp)

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

What are the 7 Rashes of the


Palms & Soles?
TSS
Rocky Mountain Spotted Fever
Coxsackie A (Hand/Foot & mouth dz)
Kawasaki
Syphillis
Scarlet Fever
Staph Scalded Skin Syndrome

What is seen in every restrictive


lung dz and low volume state?
Tachypnea
Decrease pCO2
Decrease pO2
Increase pH

What are the different 2nd


messenger systems?
cAMP
cGMP
IP3/DAG
Ca:Calmodulin
Ca+
Tyrosine kinase
NO

What is the clue for cAMP?


It is the 90%
Sympathetic
CRH (cortisol)
Catabolic

What is the clue for cGMP?


Parasympathetic
Anabolic

What are the clues for IP3/DAG?


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

What is the clue for Ca:Calmodulin?


Used by smooth muscle for contraction by
distention

What is the clue for Ca+?


Used by Gastrin only

What is the clue for Tyrosine


Kinase?
Used by Insulins
Used by ALL growth factors

What is the clue for NO?


Nitrates
Viagra
ANP
LPS

What are the T & B cell deficiencies?


WAS
SCID
CVID
HIV
HTLV-1

What are the CLUES for WAS?


Thrombocytopenia
IL-4
Infection
Eczema
Decrease IgM
IgE???

What are the CLUES for SCID?


Framshift/Nonsense mutation
Adenosine deaminase deficiency
T-cell>B-cell
Bacterial infections
Fungal infections

What are the CLUES for CVID?


Late onset
Frameshift/Missense mutation
Tyrosine Kinase deficiency

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


1 of the ETC?
Amytal
Rotenone

What are the inhibitors of Complex


2 of the ETC?
Malonate

What are the inhibitors of Complex


3 of the ETC?
Antimycin D

What are the inhibitors of Complex


4 of the ETC?
CN-
CO
Chloramphenicol

What are the inhibitors of Complex


5 of the ETC?
Oligomycin

What are the ETC chemical


uncouplers?
DNP
Free Fatty acids
Aspirin

What type of uncoupler is Aspirin?


Physical uncoupler

What are the 4 sources of Renal


Acid?
Plasma
Urea cycle
Collecting ducts
Glutaminase

What is the one dose tx for


Hemophilus ducreyi?
Azithromycin
1 gram po
Ceftriazone
250 mg im

What is the one dose tx for


Chlaymdia?
Azithromycin
1 gram po

What is the one dose tx for


Candidiasis?
Ketoconazole
150mg

What is the one dose tx for Vaginal


Candidiasis?
Difluccan
1 pill

What is the one dose tx for


Trichomonas?
Metronidazole
2 grams

What is the one dose tx for


Gardnerella?
Metronidazole
2 grams

What are the 3 cephalosporins & doses


used as one dose treatments for
Gonorrhea?

Ceftriaxone
250 mg im
Cefixime
400 mg po
Cefoxitin
400 mg po

What are the 3 Quinolones & doses


used as one dose treatments for
Gonorrhea?

Ciprofloxacin
500 mg po
Ofloxacin
400 mg po
Gatifloxacin
400 mg im

What are the 4 enzymes needed to


break down glycogen?

Phosphorylase (Pi)
Debranching enzyme
Alpha-1,6 Glucosidase
Phosphatase

What are the 2 enzymes needed to


make glycogen?
Glycogen synthase
Branching enzyme

What are the branching enzymes?


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

What is the rate limiting enzyme in


the break down of glycogen?
Phosphorylase (Pi)

What values do you see in


obstructive pulmonary dz?
pO2?
Normal
pCO2?
Normal or increased
pH?
Decreased

What values do you see in


restrictive pulmonary dz?
pO2?
Decreased
pCO2?
Decreased
pH?
Increased

What type of acidosis do you see


with obstructive pulmonary dz?
Respiratory acidosis

What are the Lysosomal Storage


Disease & what is the deficiency?

)DEU\V
.UDEEHV
*DXFKHUV
Niemann Pick
Tay-Sachs
Metachromatic
leukodystrophy
+XUOHUV
+XQWHUV

galactosidase
Galactosylceramide
glucocerebrosidase
Sphingomyelinase
Hexosaminidase
Arylsulfatase
L iduronidase
Iduronidase sulfatase

:KDWG]VDUHDVVRFLDWHGZLWK+/$
B27?
Psoriasis
Ankylosing spondylitis
IBD (Ulcerative colitis)
5HLWHUV6\QGURPH

What HLA is Psorisis w/RA


associated with?
HLA-13

What are the Glycogen Storage


Diseases & the deficiency?
9RQ*LHUNHV

Glucose 6 phosphate

3RPSHV

1 4 glucosidase

&RULV

Debranching enzyme

0F$UGOHV

Glycogen phosphorylase

What are 6 places of the TCA cycle where


amino acids feed in/out?

Pyruvate?
Glycine
Alanine
Serine

Acetyl CoA ?
Phenylalanine
Isoleucine
Threonine
Tryptophan
Lysine
Leucine

What are 6 places of the TCA cycle where


amino acids feed in/out?

Alpha-KG ?
Glutamate
Glutamine

Succinyl CoA?
Phenylalanine
Tryptophan
Tyrosine

What are 6 places of the TCA cycle where


amino acids feed in/out?

Fumerate ?
Proline
Oxaloacetate?
Aspartate
Asparigine

What are the 4 steps of B-


oxidation?
Oxidation 7 NADH 21 ATP
Hydration
Oxidation - 7FADH 14 ATP
Thiolysis 8 AcCoA 96ATP
131 ATP 2 (to bring it
in)

What are the blood gases in


neuromuscular disease (= restrictive
blood gases)?
pO2?

Decreased
pCO2?
Decreased
PCWP?
Decreased EFLWVDSUHVVXUHSUREOHP
Respiratory Rate?
Increased
pH?
Increased
SZ?
Increased

What are 5 Hormones produced by


small cell (oat cell) lung CA?

ACTH
ADH
PTH
TSH
ANP

What Autoimmune Disease has the


following Autoimmune Antibodies?

Anti-smith
Anti cardiolipin
Anti-ds DNA

SLE

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti histone?
Drug induced SLE

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-topoisomerase?
PSS (Progressive Systemic Sclerosis)

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti TSH receptors?
Graves

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-centromere?
CREST

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-GBM?
*RRGSDVWXUHV

What does Goodpastures have


antibody to?
Type IV collagen

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-mitochondria?
Primary biliary cirrhosis

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-hair follicle?
Alopecia areata

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-IgG?
Rheumatoid arthritis

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-myelin receptors?
MS

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-gliaden?
Anti-gluten?
Celiac sprue

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-islet cell receptor?
DM Type I

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-melanocyte?
Viteligo

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-ACh receptor?
MG

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-ribonuclear protein?
Mixed Connective Tissue dz (MCTD)

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-parietal cell receptor?
Pernicious anemia

What does Pernicious Anemia have


antibody to?
Intrinsic factor

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-epidermal anchoring protein
receptors?

Pemphigus vulgaris

What does Pemphigus vulgaris


have antibody to?
Intercelluar junctions of epidermal cells

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-epidermal basement membrane
protein?

Bullous pemphigoid

What do you see with bullous


pemphigoid?

IgG sub-epidermal blisters


Oral blisters

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-platelet?
ITP

What does ITP have antibody to?


Glycoprotein IIb/IIIa

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-thyroglobulin?
Anti-microsomal?
+DVKLPRWRV

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-smooth muscle?
Anti-scl-70?
Scleroderma

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-rho (SS-A)?
Anti-la?
6MRJUHQV

What Autoimmune Disease has the


following Autoimmune Antibodies?
Anti-proteinase?
C-ANCA?
:HJHQHUV

What Autoimmune Disease has the


following Autoimmune Antibodies?
P-ANCA?
Polyarteritis nodosa

What antigen & immunoglobulin is


Polyarteritis nodosa associated
with?
Hepatitis B antigen
IgM

What are the viruses that directly cause


CA and which CA do they cause?
Papilloma virus?

Cervical CA
EBV?
Burkitts
Nasopharyngeal CA
HepB & C?
Liver CA
HIV?
.DSRVLV6DUFRPD

What are the 7 Nephrotic Patterns seen


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 common


nephrotic disease seen in kids and
when does it occur?

Min. change disease


2 wks post URI

What is the most common


vasculitity leading to rapidly
progressive glomerulonephrosis?
*RRGSDVWXUHV

What is the most common


malignant renal tumor in children?
:LOPVWXPRU

What is the most common


malignant renal tumor in adults?
Adenocarcinoma

What is the most common renal


mass?
Cyst

What is the most common renal


disease in Blacks/Hispanics?
Focal Segmental GN

What is the most common


nephrotic disease in adults?
Membranous GN

Thrombolytics & Inhibitors


What does tPA, Streptokinase, Urokinase
inhibit?
Aminocaproic acid
What doe Warfarin inhibit?
Vitamin K
What does Heparin inhibit?
Protamine Sulfate

What is the dosage of tPA?


IV push?
20mg
Drip?
40mg

What is the dosage for


Streptokinase?
IV push?
750K
Drip?
750K

What is Urokinase used for?


Used ONLY for such things as:
Feeding tubes
Central lines
Fistulas

What is Alopecia Areata?


Loss of a patch of hair

What is Alopecia Totalis?


/RVVRI$//KDLURQKHDGEDOG

What is Alopecia Universalis?


/RVVRIKDLURQHQWLUHERG\KDLUOHVV

What is Loffler syndrome?


Pneumonitis with endocarditis =
pulmonary infiltrate with severe
eosinophilia

What is Loffler syndrome also


known as?
PIE syndrome

What are the 5 Parasites associated


with Loffler Syndrome?

Necator americanus
Ankylostoma duodenale
Shistosomiasis
Strongyloides
Ascaris lumbricoides

What happens when a patient is on


prednisone for > 7 days?

Immunocompromised

What are 2 enzymes used by B12?


Homocystine methyl transferase
Methyl malonyl-coA mutase

What does Mitochondrial


inheritance mean?
No male transmission
All females pass it on

:KRDUHSWVZKRZRXOGEH
susceptable to pseudomonas and
staph infxns?

Burn patients
Cystic fibrosis
DM
Neutropenic patients

In a neutropenic patient, what do


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

What are the 3 main concepts


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 widened


S2 splitting?

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 of


blood loss?
Pericardium

Intracranial
Mediastinum
Pleural cavity
Thighs
Retroperitoneum
Abdominal cavity
Pelvis

What is the special list for


Penicillin?

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 of


anaphylaxis?
Penicillin

:KDWDUHWKH&KURQV*LIWV"
Granuloma
Ileum
Fistula
Transmural
Skip Lesion

What are the negative-stranded


RNA Clues?
Prodromal period before symptoms =

1-3 weeks
Why is there a prodromal period?
Because must switch to positive stranded
before replication

What are the clues for positive


stranded RNA?

Symptoms within 1 week or less


EXCEPTIONS:
Hanta
Ebola
Yellow fever
They are -YHVWUDQGHG GRQWKDYHWRVZLWFKWR
positive before replicating

What are the Most common


cyanotic heart diseases?

Transposition of the great arteries


Tetrology of Fallot
Truncus Arteriosus
Tricuspid Atresia
Total anomalous pulmunary Venous Return

Hypoplastic Left heart syndrome


(EVWHLQVDQRPDO\
Aortic atresia
Pulmonary atresia

What cyanotic heart disease is


boot shaped?
Tetrology of Fallot

What cyanotic heart disease is


associated with mom taking lithium
during pregnancy?
(EVWHLQV$QRPDO\

What things make the membrane


less likely to depolarize?
Hypokalemia
Hypermagnesemia
Hypercalcemia (except atrium)
Hypernatremia

What things make the membrane


more likely to depolarize?
Hyperkalemia
Hypomagnasemia
Hypocalcemia (except atrium)
Hyponatremia

What is Plan F?
TPP Thiamin B1
Lipoic Acid B4
CoA Pantothenic acid B5
FAD Riboflavin B2
NAD Niacin B3

What are the 8 x-linked inherited


diseases?

%UXWRQV$JDPPDJOREXOLQHPLD
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?


%UXWRQVDJDPPDJOREXOLQHPLD
CVID (Common Variant Imm. Def)
Leukemias
Lymphomas
SCID
WAS
Job Buckley Syndrome

What is the Tyrosine kinase


deficiency?
%UXWRQVDJDPPDJOREXOLQHPLD

What are the B-cell deficiencies


with T-cell overlap?
SCID
WAS
Job Buckley Syndrome

What are the 4 itchiest rashes?


Scabies
Lichen Planus
Urticaria
Dermatitis Herpetiformis

Tumor Markers/Oncongenes I
L-myc?
Small cell lung Ca
C-myc?
3URP\HORF\WLFOHXNHPLD %XUNLWWVO\PSKRPD
N-myc?
Neuroblastoma
Small cell lung CA
C-able?
CML
ALL

Tumor Markers/Oncongenes II
C-myb?
Colon CA
AML
C-sis ?
Osteosarcoma
Glioma
Fibrosarcoma

Tumor Markers/Oncongenes III


C-erb B2?
Epidermal growth factor receptors
CSF-1 ?
Breast

Tumor Markers/Oncongenes IV

Erb-B2?
Breast CA
Ovarian CA
Gastric CA

Ret?
Medullary CA of thyroid
Men II & III
Papillary carcinoma

Tumor Markers/Oncongenes V
Ki-ras?
Lung CA
Colon CA
Bcl-2?
Burkitts
Follicular lymphoma
Erb?
Retinoblastoma

What are 6 Hormones produced


by the placenta?
hCG
Inhibin
Human placental lactogen (HPL)
Oxytocin (drug lactation, pit gland prod it
also)
Progesterone
Estrogen
Relaxin

What is cancer grading?


Severity of microscopic change
Degree of differentiation

What is cancer staging?


Degree of dissemination of tumor
What the surgeon sees

What are the rashes associated


with cancer and what cancer are
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 associated


with cancer and what cancer are
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 associated


with Cancer and the cancer they
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?


Apo E
Apo A
Apo CII
L-CAT
lecithin cholesterol acetyl transferase

Cholesterol
from periphery to liver

What is carried by VLDL?


Apo B-100
Apo E
Apo C II
Triglcyerides (95%)
Cholesterol (5%)

What is carried by IDL?


Apo B-100
Apo E
Apo CII
Triglycerides (< VLDL)
Cholesterol (>VLDL)

What is carried by LDL?


Apo B-100
Cholesterol
from liver to tissue

NOT a good thing!!!!!

What do chylomicrons carry?


Apo A
Apo B-48
Apo E
Apo C II
Triglycerides from:

GI to liver (25% of the time)


GI to endothelium (75% of the time)

Which lipoprotein carries the


most cholesterol?

LDL

Where are the AVMs?


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

:KDWLVWKH5DQVRQVFULWHULDIRU
acute pancreatitis (at admission)?
Glucose > 200
Age > 55
LDH >350
AST > 250
WBC > 16,000

:KDWLVWKH5DQVRQVFULWHULDIRU
acute pancreatitis (at less than
48 hrs)?
Calcium <8 mg/dl
HCT drop > 10%
O2 < 60 (PaO2)
Base deficit > 4
BUN > 5 mg/dl
Sequestration > 6L

What 2 diseases is pilocarpine


used for?
CF
Glaucoma
Painful, red, teary eye

What is dysguzia?
Problem with sense of taste

What are 3 causes of dysgusia?


Metronidazole
Clarithromycin
Zinc deficiency

What is the triad of Carcinoid


syndrome?
Flushing
Wheezing
diarrhea

What do you measure for carcinoid


syndrome?
Serotonin
5-HIAA

Where are the 2 most common


places a carcinoid tumor is
found?
Pancreas
Ileum

What are the phage mediated


toxins?
Mnemonic: BEDS
Botulinum
Erythrogenic toxin
from strep pyogenes

Diptheria
Salmonella
Has O antigen

What is the story used to


remember the segmented RNA
viruses?
I sprayed ORTHO on my BUNYA at the
ARENA down in REO to kill
SEGMENTED WORMS

Name the 3 major types of


adhesion molecules
ICAMs
Integrins
Selectins

What does IgCam do?


Bind proteins

What do integrins do?


Stop the leukocytes

What do selectins do?


Bind carbohydrates
Mediate the rolling to slow leukocytes
down

What are the functions of adhesion


molecules?
Homing of lymphocytes
tells lymphocytes where to go

Inflammation
Cell-cell interaction

Primary allergic response is due


to what?
Contact

What cells are present in the first 3


days?
Neutrophils
The next cells to show up are?
B-cells
What do B-cells make?
IgM

What day does IgM show up?


Three
IgM peaks at what day?
14
When does IgM leave?
In 2 months

What shows up in 2 wks (14 days)?


IgG
When does IgG peak?
In 2 months
When does IgG leave?
In 1 year

What is Secondary Allergic


response is due to?
MEMORY

What shows up at day 3?


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?


IgG

What are the risk factors for


Esophageal/Gastric CA?
Smoking
Alcohol
Nitrites
Japanese

What are the risk factors for


bladder CA?

Smoking
Aniline dyes
Benzene
Aflatoxin
Cyclophosphamide
Schistosomiasis
2 diseases:
Von Hippel-Lindau
Tubular sclerosis

What is the NBT test?


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

What disease corresponds with the


following inclusion bodies?
Howell-Jolly?
Sickle cell
Heinz?
G-6-P-D
Zebra?
Niemann pick

What disease corresponds with the


following inclusion bodies?
Donovan?
Leishmaniasis
Mallory?
Alcoholism
Negri?
Rabies

What disease corresponds with the


following inclusion bodies?
Councilman?
Yellow fever
Call-exner?
Ovarian tumors
granulosa origin

What disease corresponds with the


following inclusion bodies?
Lewy?
Parkinsons
Pick?
3LFNVGLVHDVH
Barr body?
Normal female

What disease corresponds with the


following inclusion bodies?
Aschoff?
Rheumatic fever
Cowdry type A inclusions?
Herpes virus
Auer rods?
AML

What disease corresponds with the


following inclusion bodies?
Globoid?
.UDEEHVO\VRVRPDOVWRUDJHGLVHDVH
Russell?
Multiple myeloma

What disease corresponds with the


following inclusion bodies?
Schiller-Duvall?
Yolk sac tumor
Basal bodies?
Only found in smooth mm

What are the 4 types of


hypersensitivities?
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 of


Type I hypersensitivity?
Atopic
IgE (Asthma) binds to mast cell
IgA activates IP3 cascade degrading mast
cells

What are the Characteristics of


Type II hypersensitivity?
Humoral
What are examples of type II?
Rh disease
Goodpastures
Autoimmune hemolytic Anemia
All Autoimmune diseases
except RA and SLE

What are the Characteristics of


Type III hypersensitivity?
Ag-Ab complement
What are examples of Type III?
RA
SLE
Vasculitides
Some GN?

What are the Characteristics of


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

What structures have no known


function?
Appendix
Epithalamus
Palmaris longus
muscle

Pancreatic polypeptide
hormones in F-cells

What diseases can progress to


RPGN?
Goodpastures
Wegeners
DM
HTN

What are causes of papillary


necrosis?
Vasculitis
AIDS

Cytic fibrosis Questions?


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?


What is the value in a normal person?
<20
What is the value in a heterozygous person?
30 60
What chromosome is the CF gene on?
Chrom 7

What Second messenger is used?


IP3/DAG

What are the gram +ve spore


formers?
Bacillus anthracis
Clostridium perfringens
Clostridium tetani
Clostridium melangosepticus
What is the chemical in spores?
Calcium dipocholinate

What does strep mutans


ferment?
Lactic acid

What type of receptors do all


sphincters in the body have?
Alpha-receptors

Strep. Salivarius ag is used for


what test?
Cold agglutinin testing
IgM

Types of amyloid found in various


Systemic amyloidoses:

AA amyloid?
Chronic active disease
AL amyloid from Ig light chain?
Myeloma

Types of amyloid found in various


Systemic amyloidoses:

Beta 2 microglobulin?
Chronic hemodialysis
AA amyloid from SAA?
Nephrotic hereditary forms
eg. Mediterranean fever

Types of amyloid found in various


Systemic amyloidoses:

Pre-albumin/transthyretin?
Cardiomyopathic hereditary forms
senile systemic amyloidosis

Neuropathic hereditary syndromes

Types of amyloid found in various


Local amyloidoses:
ANP fibrils are caused by?
Senile cardiac amyloisosis
&HUHEUDODP\ORLGLQ$O]KHLPHUVGLVHDVH'RZQV"
Cerebral amyloidosis

Types of amyloid found in various


Local amyloidoses:
Calcitonin precursors?
Medullary CA of thyroid
AL from light chains?
Isolated, massive, nodular deposits
lung, skin, urogenital tract

What type of dementia do you


JHWLQ3LFNVGLV"
Frontotemporal dementia

'HVFULEH3LFNVGLVHDVH
Atrophy of frontal and temporal cortex
with sparing of remaining neocortical
regions

What 3 things do Pick bodies


contain?
Altered neurofilaments
Tau protein
ubiquitin

What drugs can cause a


disulfiram reaction?
Mnemonic?
CLAM
Chloramphenicol
Lactams
Cefamandole
Cefoperazone

Antabuse

disulfiram

What is the mode of action of the


Clostridium botulinum toxin?

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)
Protective factor
Edema factor

Who has Poly-D Glutamic acid?


Anthracis
Cereus

Name that B-blocker:


B1-selective?
A M
Non-selective?
N Z
Exceptions?
Carbetalol and Labetolol are non-selective

What are the 4 facts of Fanconi


Syndrome?
Problem in proximal tubule
&DQWUHDEVRUE
Low energy state causing anemia
Can be due to old tetracycline

Where is glutaminase found?


In the collecting duct of the kidney
What does glutmainase help the kidney
absorb?
Ammonia if the liver fails

Name 3 anatomical spots where


renal stones get stuck:
Hilum
Pelvic brim
Entering the bladder

Renal failure is the most common


cause of death in what 3 diseases?
SLE
Endometrial CA
Cervical CA

What is the rate-limiting enzyme


in the urea cycle?
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 does


heparin have?

-ve charge

What type of charge does


protamine sulfate have?

+ve charge
What is it used for?
Reversing the effects of heparin

What is commonly seen in all


vasculitides?

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 the


blood to the basement membrane?

The following deveop:


Clots
DIC
Pulmonary embolism
DVT
MI
Stroke

Signs and symptoms in all


vasculitides
Tachypnea and SOB
Most common cause of death?
Heart failure

What is the MOA of Erythromycin?


Inhibits the translocation step of ribosomal
protein synthesis

What is the MOA of


Chloramphenicol?
Inhibits ribosomal peptidyl transferase in
prokaryotes

What is the MOA of Puromycin?


,QKLELWVHORQJDWLRQE\ELQGLQJWR$VLWH

and prematurely terminating chain growth


in pro and eukaryotes

What is the MOA of Streptomycin?


Causes misreading of code during
initiation in prokaryotes

What is the MOA of Tetracycline?


Prevents binding of aminoacyl-t-RNA to
ribosome on prokaryotes therefore
inhibiting initiation

What is the MOA of


Cyclohexamide?
Inhibits ribosomal peptidyl transferase in
eukaryotes

cell wall inhibitor

What is the MOA of Rifampin?


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

What is the MOA of Vancomycin?


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-

carboxylation of prothrombin and factors


2, 7, 9, 10, proteins C & S

What is the MOA of Clindamycin?


Blocks translation by binding the 50S
subunit

Hemolytic properties of
Streptococcus:
What type of hemolysis is alpha hemolysis?
Partial hemolysis
:KDWFRORULVLWV]RQH"
Green
What type of hemolysis is beta-hemolysis?
Complete hemolysis

Hemolytic properties of
Streptococcus:
:KDWFRORULVLWV]RQH
Clear
eg. Streptokinase

What type of hemolysis is gamma-hemolysis?


No hemolysis

:KDWFRORULVLWV]RQH"
Red

What are the 5 notable things


about RTA I?
High urine PH (??????not sure about this)
Acidosis
UTI s
Stones
Babies die < 1 yr old

What are 3 notable things about


RTA II?
Acidosis
urine PH = 2, normal is 5-6

Hypokalmia
Patients have NO carbonic anhydrase

What are 3 notable things about


RTA III?
It is a combination of RTA I & III
Normal urine pH
Hypokalemia

What are 3 notable things about


RTA IV?
Seen in diabetics
Hyperkalemia
NO aldosterone b/c JG apparatus has
infarcted

What are the members of


Streptococcus Group D?
Viridans
Mutans
Sanguis
Salivarius
Bovis

What Steptococcus has green


pigment?
Viridans

What Streptococcus causes


SBE?
Viridans

What Streptococcus causes


cavities?
Mutans

What do you see in Nephritic


Syndrome?
HTN
Hematuria
RBC casts

What do you see in Nephrotic


Syndrome?
Increase Edema
Increase Lipidemia
Increase Cholesterolemia
Increase Coagulability
Decrease serum Albumin
Increase urinary Albumin

What is the #1 cause of Sinusitis,


Otitis, Bronchitis, Pneumonia?
Strep. Pneumo
What is the #2 cause?
Hemophilus influenza
What is the #3 cause?
Neisseria meningitides

What is the #1 method to


paralyze cilia?
Viruses
Which are secondary to what?
Bacterial infections
What is the #2 method to paralyze cilia?
Smoking

If you develop gastroenteritis


within 8hrs of eating what are the
most common likely bugs?
Staph aureus
Clostridium perfringens
%DFLOOXVFHUHXVIURPZKDW"
Fried rice

Gastroenteritis within 8hrs of eating


what toxin?
Preformed

What does Clostridum tetani


inhibit?
Release of glycine from spinal cord
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
Followed by?
Proteus
Followed by?
Klebsiella

The most frequent cause of UTI in


females between 5-10?
Staph saprophyticus
Why?
They stick things in themselves

18-24 yoa?
Staph saprophyticus
Why?
Because they stick things inside themselves

:K\QR87,VDIWHU"
Because women are use to penises and Staph saprophyticus lives on
penis (becomes part of normal flora).

Staph aureus is the most


common cause of what bone
disease?
Osteomyelitis

Because of what?
Collagenase

What is the Most Common cause of


infections one week post burn
injury?
Staph. aureus

What is the triad of SSSS?


Shock
Rash
Hypotension

Most common cause of UTI?


E. coli
Then?
Proteus
Then?
Klebsiella

Newborn meningitis is caused


by?
Group B Strep (agalactiae)
E. coli
Listeria

What is normal rectal flora from


mom
Group B Strep (Strep. Agalactiae)
E. coli
Listeria

What is associated with colon


CA?
Clostridium melanogosepticus
Strep bovis
What color pigment is produced?
Black

What Ig do you look for with


affinity?
IgG
What about Avidity?
IgM

What is transduction
9LUXVLQMHFWLWV'1$LQWREDFWHULD

What is transformation?
9LUXVLQMHFWVLWV'1$LQWRLWEDFWHULDLQD
hospital or nursing home setting, then
becomes deadly.

Conjuction occurs only with


what?
Bacteria with Pili

What causes mutiple cerebral


abscesses in newborns?
Citrobacter

What are the 2 gram ves that are


strict anaerobes?
Hemophilus influenza
Neisseria

What type of complement problem


do you have in recurrent infections
with encapsulated organisms?
C3

What does complement fight


against?
Gram negative bacteria

What do you see in serum with


prerenal failure and what are the
values?
BUN
>20

Fractional Na+ excertion


<1%
Creatine
>40

What do you see in Renal failure


and what are the values?
BUN
10-15
Fractional Na+ excretion
>2%
Creatinine
<20

What is the extravasation order?


Pavementing
Margination
Diapediesis
Migration

What is the rate limiting enzyme


for Glycolysis?
PFK-1

What is the rate limiting enzyme of


Gluconeogenesis?
Pyruvate Carboxlyase

If treating a disease that initiates


the cell mediated response, what
are you treating first?
Viral

If resistant to tx, what next?


Fungal
Mycobacterium
Protozoa
Parasite
Neoplasm

What bugs can you pick up


during birth?
Step. Group B
Strep agalactiae

Strep. Pneumonia
Herpes simplex virus
Neisseria gonorrhea
Chlyamydia

What is another name for


Adenoma sebaceum?
Perivascular angiofibromata

What is another name for


$GGLVRQV"
Primary Adrenocoritcal Insufficiency

What is another name for


Alkaptonuria?
Ochronosis

What is another name for


Churg-Strauss?
Allergic Granulomatosis
Angiitis

What is another name for


Craniopharyngioma?
Ameloblastoma
What is Ameloblast?
Tooth material

What is another name for


Chrons?
Regional enteritis
Granulomatous ileitis
Ileocolitis

What is another name for


'H4XHUYDLQV"
Subacute Granulomatous Thyroiditis

What is another name for


Intraductal Ca?
Comedo Ca

What is another name for I-Cell


Disease?
Mucolipidosis II

What is another name for


Kawassaki Disease?
MLNS
Mucocutaneous Lymph Node Syndrome

What is another name for


Leydig cells?
Interstitial cells

What is another name for


Sertoli cells?
Sustentacular cells

What is another name for


Temporal arteritis?
Giant cell arteritis (granulomatous)

What is another name for


:DOGHQVWURPVPDFURJOREXOLQHPLD"
Hyperviscosity syndrome

HHV I causes?
Oral
Trigeminal ganglia

HHV II causes?
Genital
Sacral plexus

HHV III causes?


Varicella zoster

HHV IV causes?
EBV
Mononucleosis
%XUNLWWV

HHV V causes?
CMV
Inclusion bodies

HHV VI causes?
Roseola
Duke Disease
Exanthem subitum

HHV VII causes?


Pityriasis rosea

HHV VIII causes?


.DSRVLVVDUFRPD

Answer the following questions


about Coumadin/Warfarin.
What is the MOA?
Interferes with normal synthesis and gama
carboxylation of Vit. K dependent clotting
factors via vitamin K antagonism.

Is it long or short acting?


Long half-life
8-10 hours to act

Answer the following questions


about Coumadin/Warfarin.
Clinical use?
Chronic anticoagulation
Contra-indication?
Pregnancy because it can cross the
placenta

Answer the following questions


about Coumadin/Warfarin.
What pathway does it affect?
Extrinsic pathway
What does it do to PT?
Prolongs
PT

Answer the following questions


about Coumadin/Warfarin.
What are the toxicities?
Bleeding
Teratogenic
Drug-drug interactions
How is it activatied?
Tissue activated

Answer the following questions


about Coumadin/Warfarin.
Administration?
po

What are the Vitamin K dependent


clotting factors?
II
VII
IX
X
Protein C
Protein S

Answer the following questions


about Heparin.
What is the MOA?
Catalyzes the activation of antithrombin III
Decreases thrombin and Xa
Is it long or short acting?
Short half-life
Acts immediately

Answer the following questions


about Heparin.
Clinical use?
Immediate anticoagulation of pulmonary
embolism, stroke, angina, MI, DVT.

Contra-indication?
Can be used during pregnancy because it
does not cross the placenta

Answer the following questions


about Heparin.
What pathway does it affect?
Intrinsic pathway
What value should you follow?
PTT

Answer the following questions


about Heparin.
What are the toxicities?
Bleeding
Thrombocytopenia
Drug-drug interactions
How is it activatied?
Blood activated

Answer the following questions


about Heparin.
Administration?
I.V.
Drug of choice for what?
DVT

Answer the following questions


about Heparin.
What is good about the newer low-

molecular-weight heparins?
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 reversal


of heparinization?
Protamine sulfate

How do you treat Lead Poisoning?


Dimercaprol

How do you treat Benzodiazepine


poisoning?
Flumazenil

How do you treat


Anticholinesterase poisoning?
Pralidoxime

How do you treat Iron poisoning?


Deferoxamine

How do you treat Opioid poisoning?


Naloxene

How do you treat Barbituate


poisoning?
Bicarbonate
Doxapram

What does Doxapram do?


Activates the respiratory center in the
brain

What is the treatment for


Hypercholesterolemia?
Provostatin
Atrovastatin
Lovastatin
Simvastatin

What statin is renally excreted?


Provastatin

What statins do you have to follow


liver enzymes every 3 months?
Atrovastatin
Lovastatin
Simvastatin

What do statins inhibit?


HMG-CoA reductase
When is it most active?
8:00pm on

If statins are insufficient what do


you add?
Cholestipol
Cholestyramine
If nothing works what do you give?
Probucol
Niacin

What are the side effects of Niacin?


Flushing
Itching

What 2 statins bind bile salts?


Cholestipol
Cholestyramine

What are 4 causes of severe


pain (in order)?
1.Pancreatitis
Due to What?
ETOH
2.Kidney stones
Due to What?
Alcohol

What are 4 causes of severe


pain (in order)?
3.AAA
How is this described?
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
Pain (most common)
Drugs
Hypoxic Lung Disease/Restrictive Lung
disease

What drug causes SIADH?


Carbamazepine

What are the cells of neural


crest origin?

Parafollicular cells of thyroid


Odontoblasts (predentin)
Pseudounipolar cells
Spiral membrane of heart
Chromaffin cells
All Ganglion cells (Schwann, Adrenal medulla)
Melanocytes
Laryngeal/Tracheal cartilage

What are the triple repeat


diseases?
+XQWLQJWRQV
Fragile X
Myotonic Dystrophy
Prauder Willie
Spinal/bulbar muscular atrophy (Fredicks
ataxia)

How do you determine the


maximum sinus rate?
220 - age

What are the 3 low volume states


with acidosis rather than alkalosis?
RTA
Diarrhea
Diabetic ketoacidosis (DKA)

What are the causes of Croup &


Bronchiolities?
Parainfluenza
Adenovirus
Influenza
RSV

What is asthma in a child less


than 2 called?
Bronchiolitis

:KDWDUHWKH'VRI3HOODJUD"
Diarrhea
Dermatitis
Dementia
Death

What are the uric acid stones?


Cysteine
Ornithine
Lysine
Arginine

What is happening in the


Atrium?
Phase 0?
Depolarization
Phase 1?
No name
Phase 2?
Plateau phase (A-V node)

What is happening in the


Atrium?
Phase 3?
Repolarization
Phase 4?
Automaticity (S-A node)

What do Na+ channels do to


the EKG?
Wider QRS

What does Ca+ do to the EKG?


Wider P-wave
Longer PR interval

What are the types of kidney


stones?
Calcium oxalate (phosphate) stones
Struvite stones
Uric acid stones
Cysteine stones
Oxalate stones

What percent of kidney stones are


calcium oxalate?
80%

If you find oxalate stones in the


following what should you think of?
3 y/o white male?
CF
5 y/o black male?
Celiac Sprue

If you find oxalate stones in the


following what should you think of?
Adult male?
:KLSSOHV
Adult male or female?
&URKQV

If oxalate stones found in CF what


is the most common cause?
In 0-20 y/o?
Malabsorptin
What age do they die?
Young

Answer the following questions


about pseudogout?

What type of crystals are present?


Calcium pyrophosphate
Where are they found?
Joint spaces

Answer the following questions


about pseudogout?

Who gets it?


Older patients M=F
Tx?
Colchicine

What are the most common non-


cyanotic heart disease?
VSD
ASD
PDA
Coarctation

What murmur increases on


expiration?
VSD
Mitral

What murmur has fixed wide


splitting?
ASD

What murmur has bounding


pulses?
PDA

What gives you differenital


pulses?
Coarctation

What is increased incidence in


Turners?
Coarctation

What are 4 enzymes never seen


in glycolysis?
Pyruvate carboxylase
PEP carboxykinase
F-1,6 dPhosphatase
G-6-Phosphatase

What are 3 enzymes seen ONLY


in glycolysis?
Hexokinase
PFK-1
Pyruvate kinase

What are 2 hormones that are


acidophilic?
Prolactin
GH

What are the partially acid fast


Gram +ve?
Nocardia

What are the partially acid fast


Protozoa?
Cryptosporidium

What are the septic emboli of


SBE?
Mycotic aneurysm
Roth spots
Janeway lesions
2VOHUVQRGHV
Splinter hemorrhages
Endocarditis

Where are the following lesions


found?
Janeway lesions?
Toes
2VOHUVQRGHV"
Fingers
Roth spots?
Retina

What is the most common cause of


endocarditis?
Strep. viridans

What causes microsteatosis?


Acetaminophen
Reye Syndrome
Pregnancy

What causes macrosteatosis?


Alcohol

What are 2 bacteria that release


elastase?
Staph. Aureus
Pseudomonas

What are the 2 bacteria with toxins


that inhibit EF-2?
Pseudomonas
Diptheria

How does Diptheria work?


It ADP ribosylates EF2 inhibiting protein
synthesis

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
What do you give for Tx?
Antitoxin
Never scrape membrane

What are the different types of


Emphysema and their causes?
Bullous?
Staph aureus
Pseudomonas
Centroacinar?
Smoking

What are the different types of


Emphysema and their causes?
Distalacinar?
Aging
Panacinar?
Alpha-1 antitrypsin def

What are the stages of


erythropoiesis?
4 mo gestation?
Yolk sac
6 mo gestation?
Spleen, liver, flat bones

What are the stages of


erythropoiesis?
8 mo gestation?
Long bones
1 yr old?
Long bones

If long bones become damaged


after 1 yr what takes over?
Spleen can resume erythropoieses causing
splenomegaly

What ions correspond with the


following EKG?
P-wave?
Ca+
QRS complex?
Na+
S-T?
Ca+

What ions correspond with the


following EKG?
T-wave?
K+
U-wave?
Na+

What do Na+ channel blockers


do to the EKG?
QRS

What do Ca+ channel blockers


do to the EKG?
Widens P-wave
PR interval longer

P.P. Clue 4 Bio Stat

Sensitivity
Specificity
PPV
NPV
OR

A/A+C
D/B+D
A/A+B
D/C+D
AD/BC

RR

(A/All)/(C/All)

AR

(A/All)-(C/All)

A+B

C+D

A+C

B+D

ALL

Sensitivity: Truly Diseased People


Specificity: Truly Well People

+ Predictive Value: Test +ve With DZ


- Predictive Value: Tested ve w/o DZ
OR: Odds Ratio
RR: Relative Risk
AR: Attributed Risk

Always in the
numerator

A&D

In EKG P-wave Represents?


Atrium contraction
Phase zero
Calcium

In EKG P-R Interval means?


AV Node
Phase 2
Sodium

In EKG Q-Wave means?


Septum
Phase 2
Sodium

In EKG R-upstoke means?


Anterior wall
Phase 2
Sodium

In EKG S-down stroke means?


Posterior wall
Phase 2
Sodium

In EKG S-T Interval means?


Ventricle
Phase 2
Calcium

In EKG T-wave means?


Ventricle
Phase 3
Potassium

In EKG U-wave means


Ventricle
Phase 4
Sodium

4 DZ associated with HLA-DR 2?


Narcolepsy
Allergy (hay fever)
Goodpasture
MS

5 DZ associated with HLA-DR 3?


DM
Chronic active Hepititis
Sjogrens
SLE
Celiac sprue

DZ associated with HLA-DR 3&4?


IDDM (DM Type 1)

DZ associated with HLA-DR 4?


Rheumatoid Arthritis
Pemphigus Vulgaris

DZ associated with HLA-DR 5


JRA (JUV RA)
Pernicious anemia

DZ associated with HLA-DR 7?


Nephrotic syndrome (Steroid induced)

DZ associated with HLA-DR 3


and HLA-B 8?
Celiac Disease

DZ Associated with HLA-A3?


Hemochromatosis
chromosome 6
point mutation Cystine to Tyrosine

DZ Associated with HLA-A 3?


Myasthenia gravis

DZ Associated with HLA-B 13?


Psoriasis

5 DZ Associated with HLA-B 27?


Psoriasis
only if with arthritis

Ankylosing Spondylities
IBD
Ulcerative Cholitis

5HLWHUV
Post gonococcal arthritis

DZ Associated to HLA-BW 47
21 alpha hydroxylase deficiency
Vit. D

Facts about Diphtheria


ADP ribosylates EF-2
Stops cell synthesis
Gr +ve
Gets exotoxin from virus via transduction
Heart block
Its toxoid therefore give antitoxin

MCC of Pneumonia in 6wks to


18 yrs?
RSV (infants only)
Mycoplasma
Chlamydia pneumonia
Strep pneumonia

MCC Pneumonia in 18 yrs to 40 yrs


of age?
Mycoplasma
Chlamydia pneumonia
Strep. Pneumonia

MCC of Pneumonia in 40 yrs to


65 yrs of age?
Strep pneumonia
H. influenza
Anaerobes

MCC of pneumonia in the Elderly?


Strep pneumonia
Viruses
Anaerobes
H.influenza
Gr ve rods

What are 4 Clues for IgA?


Monomer in blood
Dimer in secretion
Located on mucosal surface
Found in secretion

What are Clues for IgD?


Only functions as surface marker for
Mature B-Cell

What are Clues for IgE?


Immediate hypersensitivity/anaphylaxis
Parasite defense
Worms
Fc region binds to mast cells and basophils
Allergies
Does Not fix complement

What are Clues for IgG?

Highest affinity
Memory respond at day 3 five times the concentration
Peaks in 5 years last for 10 years
Opsonizes
Activates complement
2nd 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

What are Clues for IgG2?


Most common sub-class deficiency
Patient susceptible to encapsulated
organisms

What are Clues for IgG3?


Most memory antibody

What are Clues for IgG4?


Only IgG NOT fixing complement

What are Clues for IgM?


Responds in primary response
Most efficient in agglutination and

complement fixation
Defenses against bacteria and viruses

What do Macrophages release?


MHC II

What does TH1 secrete?


IL-2
IF- Gamma

What does TH2 Secrete?


IL-4
IL-5
IL-6
IL-10

What does TH-0 secrete?


TH-1
TH-2

MHC-1 are also called what?


CD8
CD8 becomes T-cytotoxic cells

All T-Cells express what?


CD-3
For what?
Signal transduction
CD-2
For what?
Adherence

What do CD-4 cells Become?


T helper cells

What do CD-8 cells Become?


T cytotoxic cells

Neutrophils produce what enzymes


and what is their action?
Myeloperoxidase
NADPH
Will kill ALL Gr+ve
Ex..Hydrogen peroxide kills gr+

What do T-cells stimulate?


Clue 4x7=28
CD-4
B-7
CD-28

What are the Clues for Type-1


Hyperlipidemia?
Increased Chylomicron
Deficiency of Lipoprotein lipase enzyme
Defect in liver only

What are the Clues for type-2


hyperlipedimia?
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
deficiency for LDL at adipose. Receptor problem
for VLDL. Most common in General Population

What are the Clues for type-3


Hyperlipedimia?
Increased IDL
Receptor problem for APO-E

What are the Clues for Type-4


hyperlipedimia?
Increased VLDL
Lipoprotein lipase enzyme deficiency at
adipose tissue

What are the Clues for Type-5


hyperlipedimia?
Combination of Types 1&4
Increased Chylomicron and VLDL
Enzyme and receptor deficiency at C-II
Most common in diabetics

What is a Xanthoma?
Deposition of Cholesterol on elbows
Can cause what?
CAD

What is a Xanthelasma?
Deposition of Triglycerides on eyelids, face
Can cause what?
Pancreatitis

Description of
Rashes

ERYTHEMA MARGINATUM
Little red spots w/ bright red margins
Sandpapery
RF- Jones critera

ERYTHEMIA CHRONICUM
MIGRANS
Lymes disease
Target lesions (bulls eye)

MEASLES
Morbiliform rash
Preceded by cough
conjunctiivitis

ROSEOLA
Fever x 2 day
Followed by rash
ONLY ONE WITH RASH FOLLOWING
FEVER (HHV 6)

ERYTHEMA NODOSUM
Anterior aspect of leg
Redness
Tender nodules

Erythema multiforme
Red macules, target lesions
Causes: allergy, viruses
Mild: MCC virus, #2 drugs (sulfas)
Moderate: Stevens-Johnsons Syndrome
Severe: Toxic epidermal necrolysis , skin
peels off

SEBORRHEIC DERMATITIS
Scaly skin with oily shine on headline

SEBORRHEIC KERATOSIS
Stuck on warts
Due to aging

PSORIASIS
HLA-B27
Extensor surfaces
Silvery white plaques
Scaly skin
Pitted nails

VARICELLA ZOSTER HHV 3

STAGES
Red macules
Papules
Vesicles
Pustules then scabs
Different stages may appear at same
time

DERMATITIS HERPATIFORMIS
Rash and blisters on ant. thighs
Assoc. with diarrhea
Assoc. with flare up of celiac sprue

TYPHOID FEVER
SEEN WITH SALMONEALLA INFXN
Rose spots assoc. with intestinal fire

DERMATOMYOSITIS
Heliotropic rash

ERYSIPELAS
Reddened area on skin w/ raised borders
DOES NOT BLANCH

TINEEA CRURIS
Redness
Itchy groin

PITYRIASIS ROSEA
Herald patch= dry skin patches that follow
skin lines
HHV 7

TINEA VERSICOLOR
Hypopigmented macules on upper back
Presents in a V pattern
A.K.A. upside down christmas tree
Tx: Griseofulvin

What do you see in SCABIES?


Linear excoriations on belt line and finger
webs
What is the tx?
Lindane
Permethrin

What is a T-CELL DEFICIENCY?


DiGeorges
What ion imbalance will they have?
Hypokalemia
What did not form?
3rd and 4th pharyngeal pouch
What chromosome?
Deletion on chromosome 22

T-CELL DEFICIENCY
HIV
Also B-cell but less so

What is MYCOSIS FUNGOIDES?


NOT A FUNGUS
Non-Hodgkins form of cutaneous T-cell
lymphoma

What is the job of


CHYLOMICRONS?
7UDQVSRUW7*VIURP*,WROLYHUDQG
endothelium

What is the job of VLDL?


7UDQVSRUWV7*VIURPOLYHUWRDGLSRVH

What is the job of IDL?


7UDQVSRUWV7*VIURPDGLSRVHWRWLVVXH

:KDWLVVSHFLDODERXW/'/V"
ONLY ONE THAT CARRIES CHOLESTEROL

What do you develop with


HYPERTRIGLYCERIDEMA?
XANTHELASMA
Where are they located?
On eyelids and eyebrows

What do you develop with


HYPERCHOLESTEROLEMIA?

Xanthomas
Where are they located?
elbows

Where is VLDL made?


ONLY ONE MADE IN THE LIVER

What are IDL AND LDL formed


from?
ARE BREAK DOWN PRODUCTS OF VLDL

What are the clues for


HEMOPHILIUS INFLUENZA?
Gram -/+?
Pleomorphic gram (-) rods
What pattern?
VFKRRORIILVKSDWWHUQ
What type is most common?
Type A
80%

What are the clues for


HEMOPHILIUS INFLUENZA?
Capsule or no capsule?
non-encapsulated
Invasive or non invasive?
non-invasive

What are the clues for


HEMOPHILIUS INFLUENZA?
Most common cause of what?
Sinusitis
Otitis
Bronchitis

What are the clues for


HEMOPHILIUS INFLUENZA?
What is the 2nd most common type?
TYPE B

20%

Encapsulated or non encapsulated?


Encapsulated
What does it have in its capsule?
Polyribosyl phosphate in capsule
Contains IgA protease

What are the clues for


HEMOPHILIUS INFLUENZA?

Invasive or non invasive?


Invasive
What does it cause most often?
#1 cause of epiglottitis
What are the signs of epiglottitis?
Stridor
Fever
Thumb sign on xray

What are the most common causes


of MENINGITIS corresponding with
the following ages?
0-2 months?
#1. Group B strep (agalactiae)
#2. E. coli
#3. Listera

What are the most common causes


of MENINGITIS corresponding with
the following ages?
2 Months- 10 years?
#1. strep pneumonia
#2. n. meningitides
(adolescent years only)

What are the most common causes


of MENINGITIS corresponding with
the following ages?
10yrs- 21 yrs?
#1. n. meningitides

What are the most common causes


of MENINGITIS corresponding with
the following ages?
> 21 years old?
#1 S. pneumoniae

Answer the following about the


Strep. Pneumonia vaccine.
At what age is it given?
Given at 2,4,6 months
What strain does it cover?
Covers 23 strains (98% cases)

Answer the following about the


Strep. Pneumonia vaccine.
Indications?
Anyone> 65y/o
Anyone splenectomized
Sickle cell anemia

Anyone with end-organ damage


CF
RF
Nephrotic Syndrome

STREP PYOGENES is the most


common cause of what?
MCC of all throat infections
#2 MCC of all what?
Skin infections except lines

What are the STAPHYLOCOCCUS


PIGMENTS?
St. aureus?
Gold pigment
St. epidermidis?
White pigment
St. saprophyticus?
No pigment

What is the clue for RUSTY


COLORED SPUTUM?
Strep. Pneumonia
pneumococcus

Clues for GENERAL INFECTIONS


Skin Infections?
Say Staph. Aureus
Throat Infections?
Say Strep. Pyogenes
Small Intestine Infections?
Say E. coli

What disease is a NEUTROPHIL


DEFICIENCY & T,B cell deficiency?
Job Syndrome:
IL-4
Hyper IgE
What do they look like?
Red hair
Fair complexion
Female

What are the NEUTROPHIL


DEFICIENCY?
NADPH-OXIDASE DEF (CGD)
NEUTROPENIA
MYLOPEROXIDASE
Job-Buckley Syndrome

What Hepatitis B antigen is found


with an acute/recent infection?
HbC antigen
HbS antigen

What Hepatitis B antigen &


antibody is found with an
acute/recent infection?
HbC antigen
HbS antigen
HbC antibody

What Hepatitis B antigen is found


with Recent immunization within
the past 2wks?
HbS antigen ONLY

What Hepatitis B antibody is found with Recent


immunization two wks after and can be due to
vaccination immunity from a long time ago?

HbS antibody ONLY

What Hepatitis B antibody &


antigen is found with past disease
but now immune?
HbC antibody
HbS antibody
HbS antigen

What Immunogloblin is found in


Hepatitis B immunity?
IgG

What Hepatitis B antigen/antibody


is found in the chronic carrier
state?
HbS antigen for >6months
Can be with or without HbS antibody

What Hepatitis B antigen is found


with the infectious state?
HbE antigen

What Hepatitis B antibody is found


with the non-infectious state?
HbE antibody

If patient has recovered from


Hepatitis B what antigen will they
have?
NEGATIVE HbS antigen

If patient is a chronic carrier what


antigen will they have?
POSITIVE HbS antigen

:KDWGRHVWKHZLQGRZSHULRG
build in Hepatitis B?
HbE antibody
IgM HbC antibody
What disappears?
HbS antigen

What is the incubation period for


Hepatitis B?
4 to 26 wks
Average @ 8wks

How long is the acute disease


period in Hepatitis B?
4 to 12 wks

How long is the convalescence


period in Hepatitis B?
4 to 20 wks

How long is the recovery period for


Hepatitis B?
YEARS

Answer the following about HIV?

MC infection?
CMV
MCC of death?
PCP
What is p41 used for?
Just a marker

Answer the following questions


about HIV?

What does Gp120 do?


Attachment to CD4
What is Pol used for?
Integration
What is reverse transcriptase used for?
Transcription
What are p17 & p24 antigens used for?
Assembly

Answer the following questions


about HIV?

What is the normal CD4 count?


800-1200
What can the CD4 count be up to in children?
1500
When do you begin treating with 2 nucleotide
inhibitors and 1 protease inhibitor?
<500
(child at 750)

Answer the following questions


about HIV?
AIDS is defined as a CD4 count of what?
<200
With a CD4 count of <200 what do you tx
for?
PCP
What do you treat for when CD count is
<100?
Mycobacterium aviam intracellular

What are the Antioxidants?


Vitamin E
#1

Vitamin A
Vitamin C
Betakertine

What is Vitamin A a cofactor for?


Parathyroid
Along with what other cofactor?
Mg+

Too much Vitamin A will cause


what?
Hyperparathyroid
Increase Ca+
Decrease Phosphate

What will be the symptoms?


Goans
Moans
Bones
Stones

Too much Vitamin A will cause


what?
Pseudotumor Cerebri
Increase CSF production from Chorichoid
Plexus

What is the only cause of ICP that


does not cause herniation?
Pseucotumor cerebri

What does Vitamin A deficiency


cause?
Nightvision problems/nightblindness

Hypoparathyroidism
Decrease Ca+
Increase Phosphate

What is Vitamin B1?


THIAMINE
What do you get with a decrease in thiamine?
Beri Beri
What is the most common cause in US?
ETOH

What do you get with Vitamin B1


deficiency?
Wet Berry Berry
With heart failure
Dry Berry Berry
Without heart failure

What do you get with Vitamin B1


deficiency?
:HUQLFNHV(QFHSKDORSDWK\
:HUQLFNHV.RUVDNRII

:KDWLV:HUQLFNHV
Encephalopathy?
Alcoholic thymine deficiency of the
Temporal Lobe

:KDWLV:HUQLFNHV.RUVDNRII"

What needs B1 as a Cofactor?


3 Dehydrogenases
Pyruvate dehydrogenase
Alpha ketoglutarate dehydrogenase
Branch chain amino acid dehydrogenase
Transketolase

What is B2
Riboflavin
What is a physical sign of this deficiency?
Angular stomatitis
Angular cheliosis
Corneal Neurovasculazations

What is the best source of B2?


Milk
Also from FAD

What is B3?
Niacin
What is the clue?
Diarrhea
Dermatitis
Dementia
Death

What is the disease that presents


like B3 deficiency?
Hartnup Disease
What is deficient in this disease?
Tyrptophan
What is typtophan needed for?
Needed for niacin formation

What is B4?
Lipoic acid
What is the deficiency caused by this
vitamin?
Not one

What is B5?
Pantothenic acid
What is the deficiency caused by this
vitamin?
<RXJXHVVHGLWQRWKLQJ

What is B6?
Pyridoxine
What is the deficiency caused by this vitamin?
Neuropathy
Seizures

Who do you need to give B6 to?


Patient on INH

What type of anemia is seen with


B6 Deficiency?
Sideroblastic

What needs B6 as a cofactor?


ALL transaminases

What is B12?
Cyanocobalamine
What is the deficiency caused by this
vitamin?
Pernicious anemia
Neuropathy

What is the most common cause of


vitamin B12 deficiency?
Pernicious anemia

What 2 enzymes are needed for


synthesis of B12?
Methylmalonyl CoA Mutase
Homocysteine Methyl Transferase

Deficiency in Methylmalonyl CoA


Mutase leads to what?
Neuropathy

Why?
Because it recycles myelin

Deficiency in Homocystiene Methyl


Transferase leads to what?
Megaloblastic anemia
What else is this enzyme needed for?
Nucleotide synthesis

When is ANGULARE STOMATOSIS


seen?
VITAMIN B2- RIBOFLAVIN deficiency

:KDWDUHWKH'6RISHOOHJUD"
DIARRHEA
DERMATITIS
DEMENTIA
DEATH

What causes a
NEUROPATHY WHEN
DEFICIENT & also needs
TRANSAMINASE?
PYRIDOXINE B6

What vitamin is deficient


with PERNICIOUS ANEMIA
& NEUROPATHY?
B12 CYANOCOBALAMINE

What is the first vitamin to run out


with disease of rapidly dividing
cells?
Folate

What type of anemia is seen with


Folate deficiency?
Megaloblastic anemia
With neuropathy?
NO NEUROPHATHY
What else is Folate used for?
Nucleotide synthase (THF)

What is another name for Vitamin


C?
Ascorbate acid

What is Vitamin C needed for?


Collagen synthesis

What happens with Vitamin C


deficiency?
Scurvy

What is the CLUE for Scurvy?


Bleeding gums
Bleeding hair follicles

What is the most common cause of


Vitamin C deficiency?
Diet deficient in citrus fruit
Diet deficient in green vegetables
Over cooked green vegetables

What does Vitamin D do with Ca+?


Controls Ca+
Absorbes Ca+ from GI
Reabsorbs Ca+ in Kidneys
Controls osteoblastic activity

What does Vitamin D deficiency


cause in Children?
Ricketts
What does it cause in ADULTS?
Osteomalcia

What is the CLUE for RICKETTS?


Lateral Bowing of the Legs
X-linked dominant

What is Vitamin E needed for?


Hair
Skin
Eyes
Protection against free radicals
#1 antioxidant

What does a deficiency of Vitamin


E cause in newborns?
Retinopathy

What are the vitamins from GI that


are normal flora?
Folate
Vitamin K
90%

Biotin
Panothenic acid
Helps with absorption of B12

What are the Vitamin K dependent


clotting factors?
1972
Protein C
Protein S
Which one has the shortest half-life?
Protein C
Which one has the 2nd shortest half-life?
7

What are the TRACE elements?


Chromium
Selenium
Manganese Molebdenum
Tin

What is Chromium needed for?


Insulin action

What organ needs Selenium?


Heart

What trace element is an enzyme


in glycolsis?
Manganese Molebdenum

What organ needs Tin?


Hair

What does a deficiency in Zinc


cause?
Dysguzia
Decrease sperm
Dry hair
Dry skin

Cofactor for ALL Kinases?


Mg+

Cofactor for ALL Carboxylases?


Biotin

Cofactor for ALL Transaminases?


Pyridoxine
B6

What is Biotin a cofactor for?


ALL carboxylases

What is Mg+ a cofactor for?


ALL kinases
Parathyroid along with Vitamin A

What is Ca+ needed for?


Muscle contraction
Axonal transport
2nd messengers

What tracts are affected due to


deficiency in Methyl Malonyl CoA
Mutase?
Dorsal Columns
Cortical Spinal Tracts
Why are these affected?
Because they are the longest
Because they need the most myelin

What enzyme does Zanthein


Oxidase need?
Maganese Molebdenum

How are drugs that are bioavailable


ALWAYS excreted?
By the liver
Always Hepatotoxic

How are soluble drugs ALWAYS


excreted?
By the kidney
Always nephrotoxic

:KDWDUHWKH362)
COMPARTMENT SYNDROME?
Pain
Pallor
Paresthesia
Pulselessness
Poikilothermia

What are 5 skin infections were


Strep. Pyogenes is the number
one cause?
Lympangitis
Impetigo (not bullous)
Necrotizing fascitis
Erysepelas
Scarlet fever

What are 5 skin infections were


Staph. aureus is the number two
cause?
Lympangitis
Impetigo (not bullous)
Necrotizing fascitis
Erysepelas
Scarlet fever

What is the #1 bacteria causing


infection associated in shunts and
central lines?
Staph epidermitis

What is the #1 bacteria causing


infection in peripheral lines?
Staph aureus

Why do we need E. COLI in the


gut?
Absorption of Vit. B12
Synthesis of:
-Vitamin K
-Biotin
-Folate
-Pantothenic acid
B5

Answer the following questions


about RESTRICTION ENZYMES?

Trypsin cuts where?


cuts to R of
Arg
Lys
Chymotrypsin cuts where?
FXWVWR5RIEXON\DDV(aromatics)
Phe
Tyr
Trp

Answer the following questions


about RESTRICTION ENZYMES?

Elastase cuts where?


&XWVWR5RI 6$*
Ser
Ala
Gly

CNBr cuts where?


Cuts to R of
Methionine

Answer the following questions


about RESTRICTION ENZYMES?
Mercaptoethanol cuts where?
Cuts to R of: disulfide bonds
Cysteine
methionine

Answer the following questions


about RESTRICTION ENZYMES?
Aminopeptidase cuts where?
Cuts to R of
amino acid terminal
Caboxypeptidase cuts where?
Cuts to L of
carboxy terminal

What is THE ONLY LIVE VACCINE


INDICATED IN AIDS PATIENTS?
MMR

What VACCINE is NOT GIVEN IF


pt. is Allergic to EGG?
MMR & INFLUENZA

What VACCINE is NOT GIVEN IF


patient HAS YEAST ALLERGIES?
Hepatitis B

What 3 VACCINES DROP OUT


AFTER 6 YEARS OF AGE?
Hib
Diphtheria
Pertussis

What is the MC STRAIN OF STREP


PYOGENES TO CAUSE GN?
Strain 12

What 2 substances are in


NEUTROPHILS?
Myeloperoxidase
NADPH Oxidase

MACROPHAGES CONTAIN what


SUBSTANCE?
NADPH Oxidase
Which means they only kill what?
Kills only G -ve

What do MACROPHAGES SECRETE?


IL-1
IL-6??

What DRUGS CAUSE PAINFUL


NEUROPATHY?
DDI>DDC
Pancreatitis

What are the MITOCHONDRIAL


DISEASES?

/HLJKV'LVHDVH
What is another name?
Subacute necrotizing encephalomyelopathy
What are the signs & symptoms?
Progressively decreasing IQ
Seizure
Ataxia
What is the deficiency?
Cytochrome oxidase deficiency

What are the MITOCHONDRIAL


DISEASES?
/HEHUV+HUHGLWDU\2SWLF$WURSK\ /+21
They all die

What is the ONLY G +ve WITH


ENDOTOXIN?

Listeria
What part is toxic?
Lipid A
Does it cross the placenta?
Yes

What does Listeria activate?


T-cells & Macrophages, therefore, have
granulomas

What are the Associations in


contracting the Listeria bug?
Raw cabbage
Spoiled milk
Migrant workers

What are the PERIODS OF RAPID


GROWTH/RAPIDLY DIVIDING
CELLS?
Birth 2 months
4 7 years old
Puberty

What is THE ONLY IMMUNE


DEFICIENCY WITH LOW CALCIUM
and Increase Phosphate?

'L*HRUJHV6\QGURPH

What are the BASIC AMINO ACIDS?


Lysine
Arginine

What are the ACIDIC AMINO


ACIDS?
Glutamate
Aspartate

What are the Ketogenic +


Glucogenic Amino Acids?
Phenylalanine
Isoleucine
Trptophan
Threonine

What are the AROMATIC AMINO


ACIDS?
Phenylalanin
Tyrosine
Tryptophan

What are the AMINO ACIDS with


DISULFIDE BONDS?
Met
Cyst

:KDWDUHWKH.,1.<$0,12
ACID?
Proline

What are the SMALLEST AMINO


ACID?
Gly

What are the AMINO ACIDS with


O-BONDS?
Serine
Threonine
Tyrosine

What are the AMINO ACIDS with N-


BONDS?
Asparagine
Glutamine

What are the BRANCHED-CHAIN


AMINO ACIDS?
Leu
Iso
Val

What are the KETOGENIC AMINO


ACIDS?
Leu
Lys

What CONDITIONS are


ASSOCIATED WITH
HLA-B27?
Psoriasis (with arthritis)
Ankylosing Spondylitis
Irritable Bowel Syndrome
5HLWHUV6\QGURPH

What is associated with HLA-B13?


Psoriasis with out arthritis

What are the ORGANISMS WITH


IgA PROTEASE (resistant to IgA)?
Strep. Pneumoniae
H. influenza
Neisseria catarrhalis

What do EOSINOPHILS SECRETE?


Histaminase
Arylsulfatase
Heparin
Major Basic Protein

What do MAST CELLS SECRETE?


In an Acute Reaction?
Histamine
In a Late Reaction?
SRS-A
ECF-A

What is the MCC of ATYPICAL


PNEUMONIA?
0 2 months?
chlamydia pneumonia

What does chlamydia pneumonia


cause?
Intersitital pneumonia

What is the CLUE for HEART


BLOCK?
High temperature with NORMAL pulse
rate!

(This should never be! Each degree in temp. 10


beats/min in pulse rate)

What are the clues for IL-1?


FEVER
NONSPECIFIC ILLNESS
RECRUITS TH CELLS for LINKING with
MHC II COMPLEX
SECRETED BY MACROPHAGES

What are the clues for IL-2?

MOST POTENT OF THE Interleukins


RECRUITS EVERYBODY
MOST POWERFUL CHEMO-ATTRACTANT
MUST BE INACTIVATED
When must you inactivate it?
PRIOR TO TRANSPLANTATION
by cyclosporin
SECRETED BY TH1 CELLS

What are the clues for IL-3?


ENERGIZED MACROPHAGES
CAUSES B-CELL PROLIFERATION
LABELED BY THYMIDINE (USE POKEWEED
MITOGEN OR ENDOTOXIN)
SECRETED BY ACTIVATED T CELLS

What are the clues for IL-4?


B-CELL DIFFERENTIATION
RESPONSIBLE FOR CLASS SWITCHING
SECRETED BY TH2 CELLS

What are the clues for IL-5 thru


14?
They do exactly what IL-1 thru IL4

What are the clues for IL-10?


SUPPRESSES CELL-MEDIATED RESPONSE
(tells macrophages and fibroblasts to stay
away if bacterial)
INHIBITS MAC ACTIVATION

What are the clues for IL-12?


PROMOTES CELL-MEDIATED RESPONSE

(recruits macs & fibroblasts if NOT bacterial)


ACTIVATES NK CELLS TO SECRETE IF-
INHIBITS IL-4 INDUCED IgE SECRETION
CHANGES TH CELLS to TH1 CELLS
secretes IL-2 & IF- inhib. TH2, therefore, host
defenses against delayed hypersensitivity

What are the clues for IF-?

Where is it from?
LEUKOCYTES
VIRAL REPLICATION AND TUMOR GROWTH
NK ACTVITY
secretes perforins and granzymes to kill infected cell

MHC CLASS I & II EXPRESSION


PROTEIN SYNTHESIS

translation inhibited, therefore, defective protein


synthesis

Summary of clues for IF-?


Increase NK activity
Increase MHC class I & II
Decrease protein synthesis
Decrease viral replication and growth

What are the clues for IF-B?


Where is it from?
FIBROBLASTS
Increase NK activity
Increase MHC class I & II
Decrease protein synthesis
Decrease viral replication and growth

What are the clues for IF-gama?

Where is it from?
T-CELLS & NK CELLS
NK ACTIVITY
MHC CLASS I & II
MACROPHAGE ACTIVITY
CO-STIMULATES B-CELL GROWTH &
DIFFERENTIATION
IgE SECRETION

What are the clues for TNF-alpha?

Where is it from?
MONOCYTES & MACROPHAGES
What is another name for TNF-alpha?
CACHECTIN
INDUCES IL-1
ADHESION MOLECULES & MHC CLASS I ON
ENDOTHELIAL CELLS
PYROGEN
INDUCES IF- SECRETION
CYTOTOXIC/CYTOSTATIC EFFECT

What are the clues for TNF-beta?


Where is it from?
T-CELLS
What is another name for it?
LYMPHOTOXIN
CYTOTOXIC FACTOR

What are the clues for TGF-?


Where is it from?
SOLID TUMORS (CARCINOMA >
SARCOMA)
MONOCYTES

What is another name for it?


TRANSFORMING GROWTH FACTORS

What are the clues for TGF-?

What does it INDUCE?


ANGIOGENESIS
KERATINOCYTE PROLIFERATION
BONE RESORPTION
TUMOR GROWTH

What is it mainly for?


MAINLY FOR TUMOR GROWTH

What are the clues for TGF-?


Where is it from?
PLATELETS
PLACENTA
KIDNEY
BONE
T & B CELLS

What are the clues for TGF-?


What INDUCES it?
FIBROBLAST PROLIFERATION
COLLAGEN
FIBRONECTIN SYNTHESIS

What are the clues for TGF-?


What INHIBITS it?
NK
LAK
CTL
T & B CELL PROLIFERATION

What are the clues for TGF-?


What ENHANCES it?
WOUND HEALING
ANGIOGENESIS

What are the clues for TGF-?


What does it suppress?
SUPPRESSES IR AFTER INFECTION &
PROMOTES HEALING PROCESS

What is it mainly for?


MAINLY FOR WOUND HEALING

What does LAK stand for?


LYMPHOKINE ACTIVATED KILLER CELLS

What does CTL stand for?


CYTOTOXIC T-LYMPHOCYTES

What does mitochondrial


inheritance affect?
CNS
Heart
Skeletal muscle
Why does it affect these particular places?
Due to uneven cytokinesis during meiosis
or oogenesis

Answer the following about


Mitochondrial diseases?
Who are affected?
All offspring
Who passes the disease?
MOM
Who has no transmission?
Dad

Answer the following about


Autosomal Recessive inheritance?
Who does it show in?
Not parents
Siblings/uncles may show disease
When is onset?
Early in life (childhood diagnosis)
Is it complete on incomplete penetrance?
COMPLETE

Answer the following about


Autosomal Recessive inheritance?
How are they acquired?
Almost ALL are inborn error of metabolism
When does it occur?
Only when both alleles at a locus are
mutant

Answer the following about


Autosomal Recessive inheritance?
How is it transmitted?
Horizontal Tm
Are there malformations present?
Physical malformations are uncommon
What type of defect?
Enzyme defect

Answer the following about


Autosomal Dominant inheritance?
Who does it affect the most?
M=F
How does it manifest?
Heterozygote state
Who can transmit the disease?
Both parents

Answer the following about


Autosomal Dominant inheritance?
Where is the new mutation?
Often in germ cells of older fathers
When is onset?
Often delayed (adult diagnosis)
([DPSOH +XQWLQJWRQV

Answer the following about


Autosomal Dominant inheritance?
What is penetrance?
Reduced penetrance
How is it expressed?
Variable expressin
Different in each individual

Answer the following about


Autosomal Dominant inheritance?
How is it transmitted?
Vertical TM
Is there malformation present?
Physical malformation common
What type of defect?
Structural

Who is affected in the family with


an X-Linked disease?
Maternal grandfather
Maternal uncle

Immune System Time Line for viral


& cell-mediated.
What happens <24hrs?
Swelling
What happens at 24 hrs?
Neutrophils show up
What happens at day 3?
Neutrophils peak

Immune System Time Line for viral


& cell-mediated.
What happens at day 4?
T cells and Macrophages show up
What happens at day 7?
Fibroblasts show up
What happens in 1 month?
Fibroblast peak

Immune System Time Line for viral


& cell-mediated.
What happens at 3-6 months?
Fibroblasts are gone

What is the general CLUE for any


Lysosomal Storage Disease?
Lysosomal Inclusion Bodies

What are the Lysosomal Storage


diseases?

Gauchers
Fabrys
Krabbe
Tay Sachs
Sandhoffs
Hurlers
Hunters
Neiman Pick
Metachromatic Leukodystropy

What is missing in Gauchers?


Beta-Glucocerberosidase
What Accumulates?
Glucocebroside

Where?
Brain
Liver
Bone Marrow
Spleen

What are the CLUES for Gauchers?


Ask. Jew
Gargols
Gaucher cells
Macrophages looking like Crinkeled paper

Erlin myoflask legs


Pseudohypertrophy

What is missing in Fabrys?


Alpha-galactosidase
What accumulates?
Ceramide Trihexoside

What are the CLUES for Fabrys?


X-Linked recessive
Presents with cataracts as a child
Presents with renal failure as a child

What is missing in Krabbes?


Galactosylceramide B-Galactosidase
What accumulates?
Galactocerebrosidase
Where?
Brain

What are the CLUES for Krabbes?


Early death
Globoid bodies
Fat cells

What is missing in Tay Sachs?


Hexoseaminidase A
What accumulates?
GM2 Ganglioside

What is the CLUE for Tay Sachs?


Ask. Jews
Cherry red macula
Death by 3

What is missing in Sandhoffs?


Hexoseaminadase A & B

What is missing in Hurlers?


Iduronidase

What are the CLUES for Hurlers?


Corneal Clouding
Mental Retardation

What is missing in Hunters?


Iduronate Sulfatase

What are the CLUES for Hunters?


Mild mental retardation
No corneal clouding
Mild form of Hurlers
X-linked recessive

What is missing in Niemann Picks?


Spingomyelinase
What accumulates?
Spingomyelin
Cholesterol

What are the CLUES for Niemann


Picks?
Zebra bodies
Cherrry red macula
Die by 3

What is missing in Metachromatic


Leukodystrophy?
Arylsulfatase A

What is the CLUE for


Metachromatic Leukodystrophy?
Visual Disturbance
Presents like MS in 5 to 10 years of age

What are the Glycogen Storage


Diseases?
Von Gierkes
Andersons
Corys
McCardles
Pompes
Hers

What is deficient in Von Gierkes?


G-6-Pase Deficiency

What is the CLUE for Von Gierkes?


Big Liver
Big Kidney
Severe hypoglycemia
Can NEVER raise their blood sugar

What is deficient in Andersons?


Branching enzyme deficiency

What is the CLUE for Andersons?


Glycogen will be ALL LONG chains on liver
biopsy

What is missing in Corys?


Debranching enzyme

What is the CLUE for Corys?


Glycogen from liver biopsy will be ALL
SHORT branches

What is missing in McCardles?


Muscle phosporalase

What is the CLUE for McCardles?


Severe muscle cramps when exercising
High CPK

What is missing in Pompes?


Cardiac alpha-1,4 glucocydase

What is the CLUE for Pompes?


Heart problems
Die early

What is missing in Hers?


Liver phosphoralase

What is the CLUE for Hers?


Big Liver
NO big kidney

Pagets disease is associated with


what cancer?
Intraductal Ca

What MUST you rule out with a


decrease AVO2?
AV Fistula
Vasodilation

What diseases have a cherry red


macula?
Tay Sachs
Sandhoffs
Niemann Pick

What is translocation 9;22?


CML

What is translocation 11;22?


(ZLQJVVDUFRPD

What is translocation 8;14?


Burketts lymphoma

What is translocation 14;18?


Follicular lymphoma

What are the causes of restrictive


cardiomyopathy?
Sarcoid
Amyloid
Hemochromatosis
Cancer
Fibrosis
Thanks STAN!!

What are the CLUES for Vasulitis or


Intravascular Hemolysis?
Shistocytes
Burr cells
Helmet cells

What is the CLUE for Extravascular


Hemolysis?
Splenomagely

Where is Glucose 6-Pase present?


Adrenal
Liver

What is the Heinz body CLUE?


G6PD

If you see the CLUE basophilic


stippling, what should you be
thinking?
Lead poisoning

What are the Microcytic


Hypochromic Anemias?
Iron deficiency
Anemia of Chronic disease
Lead poisoning
Hemoglobinopathy
7KDOODVHPLDV
Sideroblastic anemia

What is primary sideroblastic


anemia due to?
Genetic
AD

What is secondary Sideroblastic


anemia due to?
Blood transfusions

What are the Microcytic


+\SHUFKURPLF$QHPLDV"
Hereditary Spherocytosis

What are the Normocytic


1RUPRFKURPLF$QHPLDV"
Acute hemorrhage
Anemia of Chronic Disease
Hypothyrodism
Early

Renal Failure

:KDWDUHWKH0DFURF\WLFDQHPLDV"

Folate deficiency
B12 deficiency
Reticulocytosis
ETOH
Hemolytic Anemias
Chemo Treatment
Anticonvulsants
Myelodysplasia

What are the anticonvulsants


causing a Macrocytic Anemia?
Phenytoin
Ethusuximide
Carbamyazapine
Valproate

What anemia is caused by blood


transfusions?
Sideroblastic anemia

What is the problem if you see


Eliptocytes?
Something is wrong with the RBC
membrane

Extravascular

Heridatary Ellitocytosis
Increased RET count

What disease do you get if you


have an EXCESS in Cu+?
:LOVRQV'LVHDVH

:KDWLVWKH&/8(IRU:LOVRQV
Disease?
Hepato/Lenticular Degeneration
Kayser Fleishner Rings
Copper in eyes

Hepato = Liver
Lenticular = Movement problem

What is Copper needed for?


Collagen synthesis

What disease manifest with Cu+


deficiency?
Minky Kinky Hair Syndrome

What are the plasma


catecholamines?
Epinephrine
Norepinephrine
Dopamine

What are Plasma Catecholamines


derived from?
Tyrosine

A patient with episodic HTN leading to


headache with arrhythmias leading to
palpitations most likely is diagnosed with?

Adrenal Pheochromocytoma

What is the MOA for


Fluroquinolones?
Blocks DNA gyrase (topoisomerase II)
Inhibits p450

What do Fluroquinolones cover?


All Gram + including staph auerus
All Gram
Atypicals

What are the atypicals?


Chlamydia
Ureoplasma
Mycoplasma
Legionella

What induces Gluconeogensis?


Cortisol
Epinephrine
Glucagon

What is Dermatan Sulfate?


Glycosaminoglycan chain that helps form
proteoglycans

What is Hyaluronic Acid?


Glycosaminoglycan chain that helps form
proteoglycans

What is the MOA of Methotrexate?


Inhibits dihydrofolate reductase
Inhibits DNA synthesis in the S phase of

cycle.
Prevents reduction of folic acid needed to
produce THF

What are THF derivatives used in?


Purine nucleotide synthesis
Methylation of dUMP to for dTMP

What happens when Dihydrofolate


Reductase is inhibited?
Obstructs one carbon methylation which
deprives DNA polymerase of essential
substrates

What diseases present as Failure to


Thrive?
CF
Galactosemia

In general, what should you always


DVVRFLDWH+HPRO\WLF$QHPLDVZLWK"
Defects in Glycolysis
Defects in Hexose Monophosphate Shunt

What is required for the conversion


of Homocysteine to Methionine?
B12

What is required for the conversion


of methylmalonyl CoA to Succinyl
CoA?
B12

What is required for the


degradation of cystathionine?
Vitamin B6

What does the hydroxalation of


Purines require?
Vitamin C

When does the carboxyalation of


Glutamic acid occurs and what is
required for this carboxyalation?
Occurs in the synthesis of Blood Clotting
factors
Requires Vitamin K

Decarboxylation of alpha-ketoacids
requires what?
Thiamine

Synthesis of 1,25-d-
hydroxycholecalciferol requires
what?
Vitamin D

Synthesis of Rhodopsin requires


what?
Vitamin A

Pyruvate Decarboxylase requires


what as a cofactor?
Thiamine

What is CN1?

Olfactory
What is its function?
Sensory for smell
What if lesioned?
Anosmia
Where does it Exit/Enter the Cranium?
Cribriform plate
What does it innervate?
Nasal Cavity

What is CN2?

Optic
What is its function?
Sensory for sight
What if lesioned?
Anopsia
Visual field defect

Loss of light reflex with CN III


Only nerve affected by MS

Cont. CN2
Where does it Exit/Enter the Cranium?
Optic Canal
What does it innervate?
Orbit

What is CN3?

Occulomotor
What are the functions?
Motor
Moves the eyeball in ALL directions
Adduction Most important action (MR)
Constricts the pupil (Spincter Pupillae)
Accomodates (Cililary Muscle)
Raises eyelid (Levator Palpebrae)

Cont. CN 3
What if lesioned?
Diplopia
Loss of parallel gaze
Dilated pupil
Loss of light reflex
Loss of near response
Ptosis

Cont. CN 3
Where does it Exit/Enter the Cranium?
Superior Orbital Fissure
What does it innervate?
Orbit

What is CN 4?
Trochlear
What is its function?
Motor
Superior Oblique
Depresses and abducts the eyeballs
Intorts

Cont. CN 4
What if lesioned?
Weakness looking down w/ adducted eye
Trouble going down stairs
Head tilts away from lesioned side
Where does it Exit/Enter the Cranium?
Superior Orbital Fissure

Cont. CN 4
What does it innervate?
Orbit

What is CN 5?
Trigeminal

What are the different branches of


CN 5?
V1?
Opthalmic
V2?
Maxillary
V3?
Mandibular

What is the function of CN V1?


Mixed
General sensation (touch, pain, temperature) of the
forehead, scalp, & cornea

What if lesioned?
Loss of general sensation of the forehead/scalp
Loss of blink reflex w/ VII
Where does it Exit/Enter the Cranium?
Superior orbital Fissure
Ophthalmic division

Cont. CN V1
What does it innervate?
Orbit
Scalp

What is the function of CN V2?


Mixed
General sensation of Palat, Nasal cavity,
Maxillary face, and Maxillary teeth

What if lesioned?
Loss of general sensation in skin over
maxilla & maxillary teeth

Cont. CN V2
Where does it Exit/Enter the Cranium?
Foramen Rotundum
What does it innervate?
Pterygopalatine
Leaves by openings to face, oral & nasal
cavity

What is the function of CN V3?


What is its function?
Mixed
General sensation of anterior 2/3 of tongue,

mandibular face & mandibular teeth


Motor
Muscles of Mastication and anterior belly of
digastric, mylohyoid, tensor tympani, tensor
palati

Cont. CN V3
What if lesioned?
Loss of general sensation in skin over
mandible, mandibular teeth, tongue,
weakness in chewing
Jaw deviation to weak side
Trigeminal neuralgia
Intractable pain in V2 or V3 territory

Cont. CN V3
Where does it Exit/Enter the Cranium?
Foramen Ovale
What does it innervate?
Infratemporal Fossa

What is CN VI?
Abducens
What is its function?
Motor
Lateral rectus
Abducts eye

Cont. CN VI
What if lesioned?
Diplopia

Internal strabismus

Loss of parallel gaze


Pseudoptosis

Where does it Exit/Enter the Cranium?


Superior orbital fissure
What does it innervate?
Orbit

What is CN VII?

Facial
What is its function?
Mixed
To muscles of facial expression
Posterior belly of diagastric
Stylohyoid & Stapedius
Tastes anterior 2/3 of tongue/palate
Salivates (submandibular & sublingual glands)
Tears (Lacrimal glands)
Makes mucous (nasal & palatine glands)

Cont. CN VII

What if lesioned?
Corner of mouth droops
&DQWFORVHH\H
&DQWZULQNOHIRUHKHDG
Loss of blink reflex
Hypeacusis
Loss or alteration of taste (ageusia)
Eye dry and red
Bell Palsy
Lesion of nerve in facial canal

Cont. CN VII
Where does it Exit/Enter the Cranium?
Internal Auditory meatus
What does it innervate?
Face
Nasal & oral cavity
Branches leave skull in stylomastoid foramen,
petrotympanic fissure, or Hiatus of facial canal

What is CN VIII?
Vestibulocochlear
What is its function?
Sensory
Hears
Linear acceleration (Gravity)
Angular acceleration (Head Turning)

Cont. CN VIII
What if lesioned?
Loss of Balance
Nystagmus
Where does it Exit/Enter the Cranium?
Internal Auditory Meatus
What does it innervate?
Inner ear

What is CN IX?
Glossopharyngeal

What is its function?


Mixed
Sense Pharynx
Carotid sinus/body
Salivates (parotid glands)
Tastes and senses posterior 1/3 of tongue

Cont. CN IX
What is its function?
To one muscle only (stylopharyngeus)
What if lesioned?
Loss of Gag Reflex with X
Where does it Exit/Enter the Cranium?
Jugular Foramen

Cont. CN IX
What does it innervate?
Neck
Pharynx/Tongue

What is CN X?

Vagus
What is its function?
Mixed
To muscles of palate & pharynx for swallowing
except tensor palate (V) & Stylopharynegeus
(IX)
To all muscles of Larynx (phonates)
Senses Larynx & Laryngopharynx
Senses Larynx & GI tract
To GI tract smooth muscle & glands in forgut &
midgut

Cont. CN X

What if lesioned?
Nasal speech
Nasal regurgitation
Dysphagia
Palate drop
Uvula points away from pathology
Hoarseness/fixed vocal cord
Loss of gag reflex w/ IX
Loss of cough reflex

Cont. CN X
Where does it Exit/Enter the Cranium?
Jugular Foramen
What does it innervate?
Neck
Pharynx/Larynz
Thorax/Abdo

CN X Sympathetics to Head
What is its function?
Motor
Raises eyelid (superior tarsal muscle)
Dilates pupil
Innervates sweat glands of face & scalp
Constricts blood vessels in head

Cont. CN X
What if lesioned?
Horner syndrome
Eyelid droop (ptosis)
Constricted pupil (miosis)
Loss of sweating (anhydrosis)
Flushed face

Cont. CN X
Where does it Exit/Enter the Cranium?
Carotid canal on internal carotid artery
What does it innervate?
Orbit
Face
Scalp

What is CN XI?
Accessory
What is its function?
Turns head to opposite side
sternocleidomastoid

Elevates & Rotates scapula


Trapezius

Cont. CN XI
What if lesioned?
Weakness turning head to opposite side
Shoulder droop
Where does it Exit/Enter the Cranium?
Jugular Foramen
What does it innervate?
Neck

What is CN XII?
Hypoglossal
What is its function?
Moves tongue
What if lesioned?
Tongue points toward pathology on protrusion

What is CN XII?
Where does it Exit/Enter the Cranium?
Hypoglossal Canal
What does it innervate?
Tongue

What are the muscles of


mastication?
Temporalis
Masseter
Medial Pterygoids
Lateral Pterygoids

What part of the brain deals with


problem solving?
Frontal Lobe

What happens if there is a lesion to


the Optic nerve?
Unilateral Blindness

What happens if there is a lesion to


the Optic Chiasm?
Bitemporal Hemianopia

What is a Berry Aneurysm due to in


the Circle of Willis?
SUBARACHNOID Hemorrhage

What is a CLUE for


SUBARACHNOID Hemorrhage?
The worse headache of my life

What effect does Pernicious


Anemia have on the nervous
system?
Causes degeneration of the posterior
columns
Causes degeneration of the CST
Loss of proprioception
Upper motor neuron defect

What does the diencephalon


originate from?
Forebrain

What originates from the


Diencephalon?
Thalamus
3rd Ventricle

Where does the Telencephalon


originate from?
Forebrain
Prosencephalon

What originates from the


Telencephalon?
Cerebral Hemispheres
Lateral Ventricles

What originates from the


Mesencephalon?
Midbrain
Aqueduct

What originates from the


Hindbrain?
Metencephalon
Myerencephalon

What originates from the


Metencephalon?
Pons
Cerebrum

What originates from the


Myerencephalon?
Medulla

What does the Jugular Foramen


contain?
CN IX
CN X
CN XI
Internal Jugular Vein
Spinal accessory nerves

What does the Foramen Spinosum


contain?
Middle menningeal artery
Branch of the maxillary artery

What does the Foramen Ovale


contain?
CN V3

What does the Foramen Magnum


contain?
Vertebral arteries
Brain stem
Spinal roots of CN XI
Spinal cord

What does the Optic Canal contain?


Opthalmic artery
Central retinal vein
CN II

What does the Hypoglossal Canal


contain?
CN XII
Hypoglossal nerve

What does the Carotid Canal


contain?
Internal Carotid artery

What does the Posterior Condylar


Canal contain?
Large Emissary Vein

What are signs of an UPPER motor


neuron damage?
+ Babinski sign
Spastic Paralysis
Hyperactive Deep Tendon Reflexes

What are signs of a lower motor


neuron defect?
Atrophy
Fasciullations
Flaccid Paralysis
Loss of deep tendon reflexes

What does it mean to see a physis


on radiograph?
Means the skeleton is not fully mature

When does Physis disappear?


Once growth is complete

What is a nonunion fracture?


Fracture that does not heal with in 6
months

What does Malunion mean?


A fracture that heals in an Abnorman
position

What is a characteristic feature of


cancellous (spongy) bone?
Trabeculae

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CN III
Oculomotor nerve

CN IV
Trochlear nerve

CN VI
Abducens nerve

What CN is responsible for turning


the head and shrugging the
shoulders?
CN XI
Accessory nerve

What CN has sensory fibers for


Face and Motor fibers for muscles
of mastication?
CN V
Tigeminal Nerve

What CN controls tongue


movement?
CN XII
Hypoglossal nerve

What CN controls sensory fibers for


Vison
CN II
Optic nerve

What CN senses fiber for smelling?


CN I
Olfactory

What does the Mesenteric Artery


Supply?
Distal 1/3 of transverse colon
Descending colon
Sigmoid colon
Upper Portion of Rectum

What does the Superior Mesenteric


Artery Supply?
Duodenum
Jejunum
Ileum
Cecum
Appendix
Ascending colon
Proximal 2/3 of transverse colon

What does the common Iliac artery


supply?
Pelvis
Perineum
Leg

What does the Celiac trunck give


rise to?
Left gastric artery
Splenic artery
Common hepatic artery

What do the Left. Gastric Artery,


Splenic Artery, & Common Hepatic
artery supply?
Esophagusa
Stomach
Duodenum
Liver
Gallbladder
Pancreas

If there is a lesion in the frontal


lobe will you have motor or sensory
defects?
Motor

If patient has a visual field defect


with cognitive Distrubance, what
part of the brain will be affected?
Temporal or Partial Lobe

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