Pass Program

Clues

You aint told me squat till

you tell me the CLUE!!!

What are the 5 bacteria

causing Heart Block?
Lyme Disease
Salmonella typhii (typhoid)
Chagas Disease (Whipples)
Legionella
Diptheria
Lets Stop Doing Long Contractions

What bacteria cause

Reiters Syndrome?
Shigella
IBD
Crohns

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
Car Grabs Queens

Tets to Rev Up
Alcoholic doing drugs
and stinking up car

Barbiturates
Alcohol
Griseofulvin
Carbamazapine
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 are the X-Linked

enzyme Deficiencies?
G6-PD
CGD
Pyruvate dehydrogenase Def.
Fabrys
Hunters
Lesch-nyhan
Lesch-Nyhan Hunter Puts Fabrys on G6
Clothes

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= Narcolepsy, Allergy,

Goodpastures, MS
HLA-DR3= DM, Chronic Active Hepatitis,
Sjogrens, SLE, Celiac Sprue
HLA-DR3 & 4= IDDM(Type I)
HLA-DR4= Rheumatoid Arthritis,
Pemphigus Vulgaris
HLA-DR5= JRA, Pernicious Anemia
HLA-DR7= Nephrotic Syndrome(Steroid
induced)

HLA-Antigens
HLA-DR 3 & B8=Celiac Disease
HLA-A3= Hemochromatosis(chromo. 6,
point mut.-cysteine>tyrosine)
HLA-B8=MG
HLA-B13= Psoriasis
HLA-B27= Psoriais(only if w/arthritis)
Ankylosing Spondylitis, IBD, Reiters,
Postgonococcal 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

What are the Big Mama

anaerobes?
Strep bovis
Clostridium melanogosepticus
Bacteriodes fragilis

What are the Big Mama

Rx?
Clindamycin
Metranidazole
Cefoxitin

What big mama bugs are

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?
Calcified CAs

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 .

penia?
#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
Addisons Dz
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)
Alports
Bergers

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

What is the 2
to appear?

nd

CK-MB
Appears
Peaks
Gone

MI enzyme

6 hrs
12 hrs
24 hrs

What is the 3 MI enzyme to

appear?
rd

LDH
Appears
Peaks
Gone

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
TR
VSD

Decrease on

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?

Fabrys
Krabbes
Gauchers
Niemann Pick
Tay-Sachs
Metachromatic
leukodystrophy
Hurlers
Hunters

galactosidase
Galactosylceramide
glucocerebrosidase
Sphingomyelinase
Hexosaminidase
Arylsulfatase
L iduronidase
Iduronidase sulfatase

What dzs are associated with

HLA B27?
Psoriasis
Ankylosing spondylitis
IBD (Ulcerative colitis)
Reiters Syndrome

What HLA is Psorisis w/RA

associated with?
HLA-13

What are the Glycogen Storage

Diseases & the deficiency?
Von Gierkes

Glucose 6
phosphate

Pompes
1 4 glucosidase

Coris
McArdles

Debranching enzyme
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 Boxidation?

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 (b/c its a pressure problem)
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?
Goodpastures

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?
Hashimotos

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?
Sjogrens

What Autoimmune Disease has

the following Autoimmune
Antibodies?
Anti-proteinase?
C-ANCA?
Wegeners

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?
Kaposis Sarcoma

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

vasculitity leading to rapidly

progressive
glomerulonephrosis?
Goodpastures

What is the most common

malignant renal tumor in
children?
Wilms tumor

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?

Loss of ALL hair on head bald

What is Alopecia
Universalis?
Loss of hair on entire body hairless

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

Who are 4 pts who would be

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

What are the Chrons Gifts?

Granuloma
Ileum
Fistula
Transmural
Skip Lesion

What are the negativestranded 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 -ve stranded = dont have to
switch to 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

Ebsteins anomaly
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?
Ebsteins Anomaly

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?
Brutons Agammaglobulinemia
CGD (NADPH def)
DMD
Color Blindness
G6PD
Hemophilia
Lesch-Nyhan
Vit D resist. Rickets (X-linked dominant)
Fabrys
Hunters

What are the 7 B-cell

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

What is the Tyrosine kinase

deficiency?
Brutons agammaglobulinemia

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?
Promyelocytic leukemia (Burkitts lymphoma)

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

What is the Ransons criteria

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

What is the Ransons criteria

for 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?
Picks disease
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?
Krabbes lysosomal storage disease
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
Cerebral amyloid in Alzheimers
disease/Downs?
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 get in Picks dis?
Frontotemporal dementia

Describe Picks disease

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 nonselective

What are the 4 facts of Fanconi

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

Where is glutaminase
found?
In the collecting duct of the kidney
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?
Inhibits elongation by binding to A
site 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 gammacarboxylation 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

What color is its zone?

Green
What type of hemolysis is beta-hemolysis?
Complete hemolysis

Hemolytic properties of
Streptococcus:
What color is its zone
Clear
eg. Streptokinase

What type of hemolysis is gammahemolysis?

No hemolysis

What color is its zone?

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
Bacillus cereus.from what?
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

Why no UTIs after 24?

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
Virus inject its DNA into bacteria

What is transformation?
Virus injects its DNA into it bacteria

in a 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

Addisons?
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

DeQuervains?
Subacute Granulomatous Thyroiditis

What is another name for

Intraductal Ca?
Comedo Ca

What is another name for ICell 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

Waldenstroms
macroglobulinemia?
Hyperviscosity syndrome

HHV I causes?
Oral
Trigeminal ganglia

HHV II causes?
Genital
Sacral plexus

HHV III causes?

Varicella zoster

HHV IV causes?
EBV
Mononucleosis
Burkitts

HHV V causes?
CMV
Inclusion bodies

HHV VI causes?
Roseola
Duke Disease
Exanthem subitum

HHV VII causes?

Pityriasis rosea

HHV VIII causes?

Kaposis sarcoma

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?
Huntingtons
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

What are the 4 Ds of

Pellagra?
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?
Whipples
Adult male or female?
Crohns

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
Oslers nodes
Splinter hemorrhages
Endocarditis

Where are the following

lesions found?
Janeway lesions?
Toes
Oslers nodes?
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

D

A+B

C+D

A+C B+D
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)

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 HLADR 2?

Narcolepsy
Allergy (hay fever)
Goodpasture
MS

5 DZ associated with HLADR 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

Reiters
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 Tcell lymphoma

What is the job of

CHYLOMICRONS?
Transport TGs from GI to liver and
endothelium

What is the job of VLDL?

Transports TGs from liver to adipose

What is the job of IDL?

Transports TGs from adipose to
tissue

What is special about LDLs?

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?
school of fish pattern
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

What does the window

period 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?
Wernickes Encephalopathy
Wernickes Korsakoff

What is Wernickes
Encephalopathy?
Alcoholic thymine deficiency of the
Temporal Lobe

What is Wernickes
Korsakoff?

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?
You guessed itnothing

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

What are the 4 DS of

pellegra?
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

What are the 5 PS OF

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?
cuts to R of bulky aas (aromatics)
Phe
Tyr
Trp

Answer the following questions

about RESTRICTION ENZYMES?

Elastase cuts where?

Cuts to R of (SAG)

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?

Leighs Disease
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?
Lebers Hereditary Optic Atrophy (LHON)
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?

DiGeorges Syndrome

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

What are the KINKY AMINO

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 BRANCHEDCHAIN 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
Reiters Syndrome

What is associated with HLAB13?

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 IL10?

SUPPRESSES CELL-MEDIATED

RESPONSE (tells macrophages and

fibroblasts to stay away if bacterial)
INHIBITS MAC ACTIVATION

What are the clues for IL12?

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 IFgama?

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 TNFalpha?

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 TNFbeta?

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)
Example = Huntingtons

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?

Ewings sarcoma

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
Thallasemias
Sideroblastic anemia

What is primary sideroblastic

anemia due to?
Genetic
AD

What is secondary
Sideroblastic anemia due to?
Blood transfusions

What are the Microcytic

Hyperchromic Anemias?
Hereditary Spherocytosis

What are the Normocytic

Normochromic Anemias?
Acute hemorrhage
Anemia of Chronic Disease
Hypothyrodism
Early

Renal Failure

What are the Macrocytic

anemias?
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+?
Wilsons Disease

What is the CLUE for Wilsons

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 associate Hemolytic
Anemias with?
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 alphaketoacids requires what?

Thiamine

Synthesis of 1,25-dhydroxycholecalciferol 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?

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
Cant close eye
Cant wrinkle forehead
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

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

Which CNs control eye

movement?
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