Untitled Flashcards Set

epithelioid macrophages- cd14

atopic dermatitis- itchy papules in flexure regions, by IL4 and IL13 by TH2 stimulating IGE = allergen sensitization, inhibit TH1 = infections

wegeners- c anca, nose, lung, kidney, neutrophil antibodies

glucocorticoids- inhibit transcription of proinflammatory mediators and promote apoptosis of eosinophils, T cells, monocytes

scid- auto rec def of adenosine deaminase; cgd- nadph oxidase def, cat positive infections

first gen anti histamine- many side effects bc block Ch, alpha, and serotonine pathways, cognitive side effects bc cross BBB bc more lipophilic; elderly patients- give newer med like loratadine

nk cells kill cells with low mhc class 1 antigen expression ; inducing apoptosis w perforins and granzymes

chediak higashi- auto rec, lysosomal trafficking issue, immunodef, albinism, neuro issues; giant granules in neutrophils

wiskott aldrich- eczema, thrombocytopenia, combined B and T cell def

mab- monoclonal antibody; cept- receptor molecule; nib- kinase inhibitor; etanercept- soluble receptor decoy protein

TLR- macrophages and dendritic cells, recognize LPS, relese IL1,6,12,tnf alpha via NF KB signaling

rejection types- hyperacute- preformed antibodies, mottling and cyanosis; acute- less than 6 months- donor antigens cell mediated (t cell) lymphocytic infiltration, chronic- months to years- vascular thickening

TAP proteins- loaging viral cytoplasmic proteins onto MHC class 1; impacts MHC class 1 ability to activate CD8 t cells

azathioprine- inhibits purine synthesis, incorporate flase purine nucleotides into dna and rna, reduce t and b cells, ig, and il2

rituximab- against cd20, deplete b cells (eg in wegeners)

hsr type 4- cd28 on t cells with cd80/86 aka b7 on eepidermal dendritic cells; ctla4 competes with cd28 to regulate

mhc class 1 - heavy chain and b2 microglobulin

vasovagal syncope fter vaccine- diff from anaphylaxis cuz bradycardia, no resp symptoms, pallor; from stress induced cardioinhibitory vasodepressor response from pain or emotional distress

cd18- formation of integrins; absence- leukocyte adhesion def- skin and mucosal infections without purulence, delayed umbilical cord separation, peripheral leukocytosis

corticosteroids- increse neutrophil bc of demargination, decrease lymphocyte, monocyte, basophil, eosinophil

serum sickness after antivenom, nonoclona antibodies, vaccines- type 3 hsr

GVHD- after transplant rich in lymphocyte, T cells attack host- skin, liver, GI tract issues

aging- immunosenescence- less naive B and L cells, normal memory cells and antibody quality

x linked agammaglob- low B cells and igs, life threatening enteroviral, giardia, encapsulated bacteria

c5-c9- form membrane attack complexes; def = neisseria, low ch50 and ah50

lymphadenopathy- B cell proliferation in germinal centers

margination after vasodilation; rolling- E/P selectins bind to sialyl lewis x; activate integrins on nuetrophils; tight adhesion and crawling- cd18 integrins Mac1 LFA1 on neutrophils to ic adhesion molecule ICAM ; PECAM- transmigration

vanco infusion rxn- direct activation of mast cell

t cell negative selection- medulla; positive- cortex

ig fab fragment- interact w antigen; fc fragment- interact w Fc receptor immune cells, constant region of heavy chain , activate classic complement

live vs inactive polio vaccine- difference in duodenal luminal IGA, prevents attachment to intestinal epithelial cells

metalloproteinases- zinc containing enzymes, degrade EC matrix, tumor invasion thru basement membrane

KRAS activates EGFR pathway, resistant to anti EGFR drugs

activating mutation- KRAS; inactivating- APC, BRCA1, RB, TP53

RB- restricts cells from passing g1/s checkpoint

bony pain in olrder man, osteoblastic sclerotic lesions- prostate cancer; multiple myeloma- lytic lesions

NK FB transcription factor- usually inactive in cytoplasm, LPS from bacteria degrades the IKB inactivator its bound to, it then enters nucleus, promots synthesis of inf proteins

colon cancer- APC- KRAS - P53

superoxide dismutase- nuetralizes ROS; NADPH produces ROS, def = CGD

RB1 and tp53- osteosarcoma, usually at metaphyses of long bones

hereditary nonpolyposis colon cancer (lynch syndrome)- colonic adenocarc, extraintestinal cancers like endometrial; mutation in MSH2- DNA mismatch repair ; BRCA- breast and ovarian

antibody drug conjugates allow drugs to selectively target cancer cells

opioids like morphine- metabolites cleared renally so accumulate w liver failure, causing cns depression, miosis, resp depression

gaucher disease- tx w enzyme replacement- proteins, IV, endocytosis bc too big for passive diffusion and oral absorption

tylneol vs aspirin toxicity- mitochondrial dysfunction increase liver enzymes vs fatty acid metabolism disruption in reyes

congenital toxo- 2 meds to synergistically reduce dna synthesis by reducing thf cofactor for pruine synthesis

half life increases with Vd; decreases with clearance; Vd depends by body weight and composition and drug properties like lipid solubility

MABs are not eliminated by liver or kidney so dont need to adjust based on p450 enzymes

neonates- higher body water content , low plasma protein level

metformin- renally cleared

statins- muscle pain- cyp3a4 metabolism- drugs that inhibit can increase symptoms- macrolides

serotonin syndrome- neuro, GI, sympathetic, flushing; combo of meds w MAOI activity like linezolid and serotonergic meds like SSRI, tricyclics, SNRI

theophylline intoxication- seizures

amatoxins- mushrooms- inhibit RNA polymerase 2 and mrna synthesis

cold- peripheral vasoconstriction and organ vasodilation; heat- vasodilation peripheral and organ vasoconstriction to transfer heat; elderly- less sweat glands and effective epidermal area for heat transfer

niacin- precursor for NAD and NADP, deficiency - triple D; toxicitiy - flushing

mercury toxicity- no breakdown of catecholamine, rash, CNS issues

nonexertional heat stroke- high temp and neuro dysfunction; from meds like anti Cholinergic meds which impair diaphoresis

arsenic poisoning- abd pain, GI sumptoms, hypotension, GARLIC ODOR on breath; from insecticides and contaminated water; dimercaprol tx

opioid toxicity- depression of resp and neuro , pupil constriction; low temp, BP, and tidal volume

rat poison- give FFP and vitamin K for coagulopathy and bleeding

aspirin toxicity- respiratory alkalosis and metabolic acidosis; tinnitus, fever, fast breathing

ionizing radiation impact highly proliferative cells first- skin stem cells, bone marrow, intestinal crypt

aspirin toxicity- sodium bicarb tx- increase renal excretion by converting to ionized form

antidote to serotonin syndrome- cyproheptadine, antihistamine

organophosphate - inhibit Ach-ase- muscarinic and nicotinic Ch hyperstimulation; tx- atropine- comp inhibitor of musc Ach receptor; pralidoxime- ch-ase reactivating, both nic and musc symptoms; hyperbaric oxygen for co poisoning

tylenol toxicity- depletes intrahepatic glutathione stores, excess NAPQI; N-acetylcysteine- increases stores

cyanide toxicity- nitroprusside- inhibit e- transfer to o2

antich agents like atropine and scopolamine work at musc receptors; ch-ase inhibitors are tx like physostigmine

organophosphate- ach-ase inhibitor, pesticides; atropine (anti-Ch musc receptors) first then pralidoxime (ch-ase activator); neostigmine- ach-ase inhibitor also, for MG

sedation w normal vitals- benzo toxicity, given for anxiety and alc withdrawal; tx flumazenil- comp antagonist

sporothrix schenckii- contact with soil and plants,narrow based buds- yeast as body temp, nodules along lymphatic chain

psuedomonas- common in cystic fibrosis, biofilm formation from mucoid phenotype

blastomyces- broad based, southeastern US- mississippi river; lungs to skin and bone

herpes- latent in sensory ganglion, period replication = flares over time

HIV and ring enhancing lesions with mass effect- toxoplasmosis; tx- pyrimethamine, sulfadiazine

ring enhancing lesions that test neg for toxo- primary cns lymphoma, from EBV, b cells origin;

virio vulnificus- curved gram neg, sea water- oysters or wound contamination; risk factor- iron overload

pneumocystitis pneumonia- HIV patients, bilateral infiltrates, methenamine silver stain, tx- trimethoprim sulfamethoxazole

crytococcus neo- spherical yeast, thick capsule, bird droppins in soil -> inhalation -> lungs -> brain if immunocompromised

bacillary angiomatosis- in AIDs patient, bartonella- cat scratch, lesions with large endothelial cells forming small vascular channels with inflammatory infiltrate

hot tub folliculitis- psueodomas, gram neg, oxidase positive, produce green pigment, nonlactose fermenting; q says- back from vacation in resort

yersinia- tx- aminoglycosides- block 30s ribosomal subunit

pulm actinomycosis- after aspiration (alcoholics), lower lobe consolidation, air bronchograms, filamentous branching, gram pos bacteria, sulfur granules

candida albicans- budding yeast and pseudohypae, positive germ tube test (form true hyphae with no constriction)

hbesg- replication

vhl- chromosome 3p, rcc, tumor supressor, inhibits hypoxia inducible factors that activate proteins like vegf and pdgf

homeobox genes- dna binding transcription factors, role in embryo cranio-caudal organization