NBDE First Aid Side Notes- Micro/Path

question

What is a rapidly occurring cellulitis involving the submandibular, sublingual, and submental fascial spaces, possibly causing airway obstruction?
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Ludwig’s angina
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Sepsis is most commonly caused by which 2 bacteria?
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S. aureus and E. coli
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Which bacteria is used for spore testing?
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Bacillus stearothermophilus
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What bacteria is used to determine disinfectant effectiveness?
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Mycobacterium tuberculosis
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What is a cross-linked polysaccharide consisting of alternating N-acetylmuramic acid and N-acetylglucosamine residues?
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Peptidoglycan
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How do bacteria reproduce?
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Binary fission
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What are the 4 natural transforming bacteria?
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Streptococcus sp., Haemophilus sp., N. gonorrhoeae, and H. pylori
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Mycobacteria cell walls do not contain peptidoglycan, but contain _______.
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Mycolic acid
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What are the classifications of streptococcus hemolysis?
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A: Almost (Incomplete) B: Best (Complete) G: Garbage (None)
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What bacteria cause pink eye?
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Haemophilus aegyptius (Koch-Weeks bacillus)
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Most antibacterial activity occurs during which phase of bacterial growth?
answer

Log phase
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Should you give bacteriocidal and bacteriostatic drugs together?
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No, they antagonize each other
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What is the cytopathic effect?
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The host cellular morphologic and functional changes associated with viral replication and release
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What are the 2 envelope glycoproteins in influenza viruses that exhibit the majority of antigenic changes?
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Hemagglutinin and neuraminidase
question

Which 3 viruses are enteroviruses?
answer

Poliovirus, coxsackieviruses, Hep A
question

What are rodent-borne viruses called?
answer

Roboviruses
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Describe HIV.
answer

dsRNA, reverse transcriptase, gp120 (mediates attachment to CD4+) and gp41 (mediates attachment to host cell)
question

What is a potentially deadly disease in children that is associated with the use of aspirin to treat influenza or varicella?
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Reye’s syndrome
question

What is the most common reason for liver transplantation in the US?
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Hep C
question

What is often added to vaccines to slow their absorption and increase their effectiveness?
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Adjuvants
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What are hepatocarcinogenic toxins produced by Aspergillus flavus that are generally found in contaminated grains and peanuts?
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Aflatoxins
question

Most antifungal drugs target which component of fungal cell mebranes, altering their permeability?
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Ergesterol
question

Parasitic infections generally exhibit what kind of host immune response?
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IgE mediated (Type IV)
question

Does calculus directly irritate the gingiva?
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No, provides a place for plaque accumulation
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What is the most effective antiplaque mouthrinse due to its substantivity?
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Chlorohexidine
question

Which bacteria cause all types of caries in the mouth?
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Streptococcus sp.
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Which bacteria cause specifically pit and fissure caries?
answer

Lactobacillus sp.
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Which bacteria cause specifically root caries?
answer

Actinomyces sp.
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Which bacteria is increased in pregnancy?
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P. intermedia
question

Which 3 organs are very vulnerable to hypoxia?
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Heart, brain, lungs
question

What 3 drugs cause gingival overgrowth?
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Phenytoin (Dilantin, Ca2+ channel blockers (nifedipine), Cyclosporin
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What kind of calcification can be seen around intrathoracic lymph nodes and is associated with silicosis?
answer

Eggshell calcification
question

What is calcification in or under the skin that is associated with scleroderma and dermatomyositis?
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Calcinosis
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What is the most common form of necrosis?
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Coagulative necrosis
question

Which cells cannot regenerate?
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Neurons, alveolar, cardiac, skeletal, and smooth
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What is contact inhibition during epithelialization?
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When free edges of the wound epithelium migrate toward each other until they meet, signaling a stop in lateral growth
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What is an uncommon site for infarction, due to its regenerative capacity?
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Liver
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What is killed M. tuberculosis suspended in lanolin and mineral oil that is commonly used for research?
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Freund’s adjuvant
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Class I MHC surface proteins are present in ___ ____ _____. Class II MHC surface proteins are present in _____ ____.
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All nucleated cells; only APCs
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What are the 2 ways that CD8+ lymphocytes act?
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Release perforins or induce apoptosis
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What is the process by which an Ag binds to a specific TCR or IG, activating that immune cell to clonally expand into cells of the same specificity?
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Clonal selection
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How do IgG antibodies enhance NK cells effectiveness?
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Via antibody-dependent cellular toxicity
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What immune system includes all the phagocytic cells except for granulocytes?
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Reticuloendothelial system
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What are the major dendritic cells of the gingival epithelium?
answer

Langerhans cells
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What are the 2 major opsonins?
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IgG and C3b
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How are bacteria (like Staph sp) able to resist the cidal effects of peroxide?
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They contain catalase
question

Which 2 immunoglobins are the only ones that can activate complement?
answer

IgG and IgM
question

Which cells elicit most of the destruction in graft rejection?
answer

CD8 T cells
question

What are the most common types of hyperacute rejection?
answer

ABO blood mismatches
question

What are clinical examples of Type I hypersensitivity reactions?
answer

Asthma, edema, erythema, urticaria, anaphylaxis
question

How do you treat anaphylaxis?
answer

Epinephrine, then corticosteroids or antihistamines once stable
question

What is the mechanism for teratogens?
answer

Inhibit, interfere, or block metabolic steps critical for normal morphogenesis
question

What are 3 three factors of teratogen susceptibility?
answer

Variability, specific for each developmental stage, dose dependent
question

What is most common chromosomal disorder?
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Down syndrome (then Edward’s, then Patau’s)
question

Lysosomal storage diseases are most common in people of which ancestry?
answer

Eastern Europe
question

What are the causes and symptoms of cystic fibrosis?
answer

Problems with Cl- transporter; bronchiectasis, meconium ileus
question

Which skin infection has intraepidermal bullae, and is therefore more severe?
answer

Pemphigus vulgaris
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Which skin infection has subepidermal bullae, and is therefore less severe?
answer

Bullous pemphigoid
question

Right sided heart failure results in _____ edema, but left sided heart failure results in _____ edema.
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Peripheral; pulmonary
question

What is the major factor in all types of shock?
answer

Decreased CO
question

What is Virchow’s triad?
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Endothelial injury, alteration in blood flow, hypercoagulability of blood
question

What does a pulmonary embolism usually arise from?
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Deep vein thrombosis of the lower extremities
question

What is the large pulmonary embolus that obstructs the birfurcation of the pulmonary artery?
answer

Saddle embolus
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What is an embolus that begins in the venous system, but ends up in the systemic arterial system, because of an atrial septal defect. This is the only time a deep vein thrombosis can cause a stroke.
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Paradoxical emboli
question

What are the most susceptible arteries to arteriosclerosis?
answer

Aorta and coronary arteries
question

What 3 things can result from untreated hypertension?
answer

Wear out (cardiac failure), Blow out (CVA), Run out (Renal failure)
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What is the most common cause of secondary hypertension?
answer

Renal disease
question

What is a condition in pregnant patients resulting from hypertension, proteinuria, and edema?
answer

Preeclampsia
question

What is preeclampsia + seizures?
answer

Eclampsia
question

Where does the aortic dissection most often rupture, causing fatal tamponade?
answer

Pericardial sac
question

What heart valve is the most affected in IV drug users?
answer

Tricuspid valve
question

Which valve is rarely involved in rheumatic heart disease?
answer

Pulmonary
question

What is the most common cause of death from heart attacks?
answer

Arrhythmias causing ventricular fibrillation
question

What are the 2 earliest and most common signs of heart failure?
answer

Exertional dyspnea and paroxysmal nocturnal dyspnea
question

What is the most common cause of right sided heart failure?
answer

Left sided heart failure
question

What is the greatest cause of COPD?
answer

Cigarette smoking
question

What is the most common cause of secondary pulmonary hypertension?
answer

COPD
question

What are the 2 basic problems of emphysema?
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1. Lungs are fixed in inspiration, so it is difficult to exhale 2. Decreased gas exchange from decreased SA
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What is atelectasis neonatorum?
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Alveolar collapse in newborns usually due to decreased surfactant
question

What is the cause of mesothelioma?
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Asbestos exposure
question

What is pneumoconiosis caused by inhalation of cotton particles?
answer

Byssinosis
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What is the most common predisposing factor of lung abscess?
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Alcoholism (aspiration)
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What makes up the Ghon complex?
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Primary lesion + lymph node involvement
question

What is TB involving the vertebral body?
answer

Pott’s disease
question

What is the most common complication of peptic ulcer disease?
answer

Hemorrhage
question

What is soft, bulky, foul-smelling light-colored stool? When does it occur?
answer

Steatorrhea; occurs when fat is not absorbed
question

What can cause obstructive jaundice?
answer

Gallstones that block the CBD
question

What is hereditary accumulation of copper in the liver, kidney, brain, and cornea?
answer

Wilson’s disease
question

What is the most important sign of portal hypertension?
answer

Splenomegaly
question

What is the most common cause of ascites?
answer

Liver disease
question

What is the classic cause of blood in the urine in children?
answer

Poststreptococcal glomerulonephritis
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What does a positive Coombs’ test indicate?
answer

Hemolysis is mediated by antibodies attached to RBCs
question

What is toxic accumulation of unconjugated bilirubin in the brain and spinal cord?
answer

Kernicterus
question

What are classic characteristics of sickle cell anemia?
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Healing leg ulcers and recurrent bouts of abdominal and chest pain
question

How do the RBCs appear in drug-induced aplastic anemia?
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Normochromic and normocytic
question

What is iron deficiency anemia associated with upper esophageal web?
answer

Plummer-Vinson syndrome
question

In polycythemia vera, erythropoietin levels are _____ or _____. In secondary polycythemia, erythropoietin levels are ______.
answer

Normal or low; elevated
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Where is erythropoietin made?
answer

JG apparatus in the kidney
question

Which 2 diseases exhibit problems with both platelets and coagulation cascade?
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Disseminated intravascular coagulation (DIC) and von Willebrand’s disease
question

What is the most common cause of bleeding disorders?
answer

Thrombocytopenia
question

What is a decreased platelet count due to platelet consumption by thrombosis in the terminal arterioles and capillaries?
answer

TTP (Thombotic thrombocytopenic purpura)
question

What are 2 causes of qualitative platelet dysfunction?
answer

Von Willebrand’s disease and Bernard-Sollier disease
question

Hemophilia is characterized by ____ PTT, _____ PT, and _____ bleeding time?
answer

Increased PTT, Normal PT, Normal bleeding time
question

Where are clotting factors made?
answer

Liver
question

What does Warfarin inhibit formation of?
answer

Prothrombin (Factor II)
question

What does Heparin bind to and what does it inhibit?
answer

Antithrombin III; formation of thrombin
question

What is the blood glucose level for hyperglycemia?
answer

> 126 mg/dL
question

What happens when the pituitary doesn’t make enough TSH?
answer

Secondary hypothyroidism
question

What are 3 dental findings of hypothyroidism?
answer

Underdeveloped mandible, delayed tooth eruption, retained deciduous teeth
question

What can be associated with multiple endocrine neoplasms (MEN I and MEN II1)?
answer

Hyperparathyroidism
question

What are the characteristics of Conn’s syndrome?
answer

Increased aldosterone, HTN, increased Na+, Increased water, decreased K+
question

What is an oral sign of Addison’s disease?
answer

Diffuse mucosal pigmentation
question

What is hemorrhagic necrosis of the adrenal cortex that is usually associated with a meningococcal infection?
answer

Waterhouse-Friderichsen syndrome
question

What are 2 characteristics of collagen vascular diseases?
answer

Inflammatory damage to CTs and BVs and deposition of fibrinoid material
question

Which antibodies are specific for SLE?
answer

Anti-DNA and anti-Sm
question

What are the manifestations of Scleroderma?
answer

CREST syndrome: Calcinosis, Raynaud’s phenomenon, Esophageal dysfunction, Sclerodactyly, Telangiectasia
question

What is the ONLY autoimmune disease and CT disease to occur more often in men?
answer

Polyarteritis nodosa
question

What is the clinical triad with Reiter’s syndrome?
answer

Can’t see (eye inflammation), can’t pee (urethritis), can’t climb a tree (arthritis)
question

What is the sicca complex?
answer

Dry eyes, dry mouth, lymphocytic exocrine gland inflitration; associated with Sjogren’s.
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What is lymphocytic infiltration causing enlargement of the salivary and lacrimal glands that occurs in association with SLE, Sjogren’s, and leukemia, and shows an increased risk of lymphoma?
answer

Mikulicz’s syndrome
question

What enzyme is a serum marker of increased osteoblastic activity and bone formation?
answer

Alkaline phosphatase
question

What AA is an marker of increased osteoclastic hyperactivity?
answer

Hydroxyproline
question

What enzyme is a serum marker for prostate cancer?
answer

Acid phosphatase
question

Neurofibromatosis, McCune-Albright syndrome, Fanconi’s anemia, and Tuberus sclerosis are all associated with what skin manifestation?
answer

Cafe-au-lait spots
question

What is an AD disorder manifesting with short limbs and normal-sized head and trunk?
answer

Achondroplasia (dwarfism)
question

What is a periapical bone reaction/inflammatory response from a low-grade pulpal infection?
answer

Condensing/sclerosing osteitis
question

What is a possibly fatal condition caused by bone fractures where fat in the marrow is mechanically disrupted and enters the bloodstream?
answer

Fat embolism
question

What kind of medications have been associated with osteonecrosis of the jaw?
answer

Bisphosphonates
question

What is a type of rheumatoid arthritis that occurs in young people?
answer

Still’s disease
question

Do osteophytes (bone spurs) occur in osteoarthritis or rheumatoid arthritis?
answer

Osteoarthritis
question

The classic triad of scanning speech, intention tremor, and nystagmus is indicative of what disease?
answer

Multiple sclerosis
question

How is Eaton-Lambert syndrome different from Myasthenia Gravis?
answer

It is caused by a decreased release of Ach (not auto-antibodies against the Ach receptor like MG)
question

What is the most important characteristic distinguishing malignant from benign?
answer

Metastasis
question

What is indicative of immunologic response by the host to malignancy?
answer

Lymphocytic infiltration at the tumor edge
question

What protein is involved in invasion and metastasis?
answer

Cathepsin D
question

What is an embryonal type of rhabdomyosarcoma that protrudes into the lumen?
answer

Sarcoma botryoides
question

How is breast cancer different from fibrocystic disease?
answer

Fibrocystic disease is a benign process, but might increase the risk of breast cancer
question

What gene is associated with both breast and ovarian cancer?
answer

BRCA-1
question

What is the leading cause of cancer death in both men and women?
answer

Lung cancer (breast and prostate are more common, but do not more commonly lead to death)
question

Is basal cell carcinoma malignant or benign?
answer

Benign, because it almost never metastasizes, even though “carcinoma” denotes malignancy
question

What is the most common malignancy in the US?
answer

Skin cancer: Basal cell carcinoma > SCC > malignant melanoma
question

What is the leading cause of death from skin cancer?
answer

Malignant melanoma
question

What is a pancoast tumor and what are its manifestations?
answer

Tumor in the apical segment of the upper lung; hoarseness, Horner syndrome (ptosis, miosis, anhidrosis)
question

What is the most common malignancy associated with superior vena cava syndrome?
answer

Bronchogenic carcinoma
question

What condition is associated with clubbing of the fingers and toes, enlargement of the extremities, and painful swollen joints?
answer

Hypertrophic pulmonary osteoarthropathy
question

How does leukemia differ from other cancers?
answer

It starts in bone marrow and spreads to other major organs (as opposed to beginning in major organs and spreading to bone marrow)
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What is the most common type of leukemia in children? Adults?
answer

Acute lymphoblastic leukemia (ALL); acute myelogenous leukemia and chronic lymphocytic leukemia
question

What are the lymphocytes called in ALL?
answer

“Null cells”
question

What condition is characterized by a painless, progressive enlargement of lymphoid tissue caused by malignant cells called Reed-Sternberg cells?
answer

Hodgekin’s lymphoma
question

What differentiates Hodgekin’s lymphoma from Non-Hodgekin’s lymphoma?
answer

Presence of Reed-Sternberg cells
question

What confirms the diagnosis of multiple myeloma?
answer

Bence-Jones protein in the urine
question

What is a skin infection that manifests itself as sudden eruption polymorphous skin macules, papules, and occasionally vesicles with hemorrhage?
answer

Habermann’s disease
question

What 3 conditions may pheochromocytoma be associated with?
answer

Multiple endocrine neoplasias, neurofibromatosis (von Recklinghausen’s), von Hippel-Landau disease (multiple hemangiomas)
question

What is a catecholamine-secreting extra-adrenal chromaffin cell tumor?
answer

Paraganglioma

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