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5 Heart Block *6 Low Complement Hookworm 1 dose Tx for Chlamydia

(LSD Loves Company) Associated Nephrotic - Necatur Americanis - Azithromycin


- Lyme Disease Syndromes - Enterobius
- Salmonella - Serum Sickness Vermicularis "Big Mama" Anaerobes
- Chagas - SLE - Ankylostoma - Strep. Bovis
- Legionella - SBE Duodenale - Bacteroides fragilis
- Diptheria - PSGN - Trichuris Trichurium - C. melanogo-speticus
- MPGN II - Ascaris - C. difficile
Reitter's Syndrome - Cryoglobulineima Lumbriocoides
- Shigella - Strongyloides * If blood culture show
- Yersina Induce P450 S. bovis or C.melanogo-
- Crohn's (BAG for CpR QTS) X-linked Enzymes septicus = rule out colon
- IBD - Barbiturates Deficiencies cancer
- Chylamydia - Alcohol (Fabry and Lesh go
- Griseofulvin Hunting for Candy, Pie Tx for "Big Mama
Low Complement Bugs - Carbamazepine and Gum) Anaerobes
(I AM HE) - Rifampin - G6PD - Metranidazole
- Influenza - Quinidine - CGD (NADPH) - Clindamycin
- Adenovirus - Tetracyclines - Pyruvate DH - Cefoxitin
- Mycoplasma - Spironolactones - Fabry's
- Hep B & C - Hunter's Serum Values for Low
- EBV Inhibit P450 - Lesh-Nyhan Volume State
(I'D SMACK Quin) K-
Drugs Induced SLE - INH Screen Newborns Na -
(HIPPPE) - Dapsone (Please Check Before Cl -
- Hydralazine -Sulfa Drugs Going Home) pH -
- INH - Macrolides - PKU BP -
- Procainamide - Amiodarone - Congenital Adrenal
- Penicillamine - Cimetidine Hyperplasia 1 dose Tx for Gonorrhea
- Phenytoin - Ketoconazole - Biotidinase - Ceftriazxone
- Ethosuximide - Quinolones - Galactosemia - Cefixime
- Hypothyroidism - Cefoxitin
Drugs that blast BM P450 Dependent - Ciprofloxacin
- AZT (WEPTeD) Action of Steroids - Ofloxacin
- Benzene - Warfarin (KIIISS) - Gatifloxicin
- Chloramphencol - Estrogen - Kills T-cells and
- Vinblastin - Phenytoin Eosinophils Psammoma Bodies
- Theophylline - Inhibit macrophages - Papillary CA of Thyroid
Common Shaped Bugs - Digoxin migration - Serious Cystadenoma
- Vibrio - Inhibit Phospholipase A of ovary
- Campylobacter SE of Statins - Inhibit mast cell - Meningioma
- Listeria - Myositis degranulation - Mesothelioma
- H. pylori - Hepatitis - Stabilizes endothelium
- Liver enzymes - Stimulates protein synthesis Drugs that cause Cardiac
Chinese Letters Fibrosis
- Corynebacter Painful Genetial Causes of Severe - Adriamycin
Lesions Monocytosis (STELS) - Phen-Fen
Crescent Shaped Protozoa - Herpes - Salmonella
- Giardia Lamblia - Chancroid (H.ducreyi) - TB Indication for PUD
- Lymphogranuloma - EBV Surgery
TB Treatments venereum - Listeria (IHOP)
(RESPI) - Lymphogranuloma - Syphilis - Intractable Pain
- Rifampin inguinale - Hemorrhage
- Ethambutol Macrolides - Obstruction
- Streptomycin Disulfide Bonds - Azithromycin - Perforation
- Pyrozinamide (PIGI) - Clarithromycin
- INH - Prolactin - Erythromycin
- Inhibin
- GH
- Insulin
Urease +ive Bacteria IgA Nephropathies Dihydrofolate Reductase SE of Thiazides and Loop
(PPUNCHES) - Henoch-Schoenlein Purpura Inhibitors dieuretics
- Proteus (HSP) - Pyremethamine/Sulfad - Hyperglycemia
- Pseudomonas - Berger's iazine - Hyperuricemia
- Ureaplasma urealyticum - Alport's - Trimethroprim/Sulfam - Hypovolemia
- Norcardia ethoxazole - Hypokalemia
- Cryptococcus neoformans Massive Eosinophillia - Methotrexate
- H.pylori (NAACP) Macrophages in Various
- S. saprofiticus - Neoplasms Sulfa Containing Drugs Tissues
- Allergies/Asthma - Sulfonamides Brain ... Microglia
Drugs that cause Pulmonary - Addison's - Sulfonlureas Lung .. Type I Pneumo
Fibrosis - Collagen Vascular Disease - Celecoxib (COX2 inhibitor) Liver ... Kupffer
(BBAT) - Parasites Spleen ... RES cells
- Bleomycin Silver Staining Bugs Kidney ... Mesangial
- Busulfan Risk Factors for Primary Liver - Legionella LN . Dendritic
- Amioderone Cancer - Pneumocystis Skin ... Langerhans
- Tocainide - Hep B & C - H. pylori Bone .... Osteoclasts
- (Methotrexate & cormustine) - Aflatoxin - Bartonella henselae CT .. Histiocytes
- Vinyl Chloride - Candida .. Giant cells
Salmonella Typhi - Alcohol .... Epithelioid
- High fever - Carbon Tetrachloride Blood Gas w Restrictive Lung
- Rose spots - Anyline dyes Disease Rashes of Palm & Soles
- Intestinal fire - Smoking - Tachypnea (TRiCKSSSS)
- Monosytosis - Hemochrmatosis - pCO2 - TSS (Toxic Shock)
- Heart block - Benzene - pO2 - Rocky Mt. Spotted Fever
- Schistosomiasis - pH - Coxsackie A (Hand, Foot, &
Drugs that cause Myositis Mouth Disease)
(RIPS) 9 Live Vaccines Blood Gas w Obstructive Lung - Kawasaki
- Rifampin - Measles Disease - Scarlet Fever
- INH - Mumps - or normal pO2 - Syphilis
- Prednisone - Rubella - pCO2 - Staph. Scalded Skin
- Statins - Oral Polio - pH - Streptobacillus
- Rotavirus moniliformis
Encapsulated Bacteria - Small Pox MI - Enzymes
(Some Strange Killers Have - BCG Troponin I 4 Sources of Renal Acid
Pretty Nice Capsules) - Yellow Fever - appears 2 hrs - Plasma (RTA)
- Strep. Pneumo (gr. +) - Varicella - peaks 2 days - Ammonia production in the
- Salmonella - gone 7 days collection duct - 10% of Urea
- Klebsiella Autoimmune Hemolytic CKMB cycle
- H. Flu B Anemia - appears 6 hrs - Glutaminase
- Pseudomonas - PTU - peaks 12 hrs - Carbonic Anhydrase
- Neisseria - Cephalosporins - gone 2 days
- Citrobacter - -methyldopa LDH Hormones Produced by Small
- Sulfa drugs - appears 1 day Cell CA of Lung
Encapsulated Yeast - Anti-malarials - peaks 2 days - ACTH (MC)
- Cryptococcus - Penicillin - gone 3 days - ADH
- PTH
Jones Criteria Autoimmune Macrophages Deficiency - TSH
- Polyarthritis (joints) Thrombocytopenia - Chediak-Higashi - ANP
- Carditis - Aspirin - NADPH-oxidase def
- Nodules subcutaneous - Heparin 1 Dose Tx - Candidiasis
- Erythema marginatum - Quinidine 1 dose Tx for H.ducrevi - Ketoconazle - 150 mg
- Sydenham Chorea - Azithromycin - 1 gram
Pansystolic Murmurs - Ceftriaxone - 250 mg im 1 Dose Tx - Vaginal Candidiasis
- Mitral Regurg. - Diflucan - 1 pill
- Tricuspid Regurg. 1 dose TX for Gardnerella
- Ventrical Septal Defect - Metronidazole 1 Dose Tx - Trichomonas
- Metronidazole
Viruses Related to CA Cavities of Blood Loss Hormones produced by the Staph. Epidermiditis
HPV .. Cervical Cancer - Pericardium Placenta Most common infection of
EBV .. Lymphoma - Intracranial - hCG shunts and central lines
HVB . Liver Carcinoma - Mediastinum - Inhibin
HVC . Liver Carcinoma - Pleural cavity - Human Placental Lactogen How do you tell Catalase
HIV . Kaposi - Thighs - Oxytocin positive Staphylococci apart?
- Retropritoneum - Progesterone (by pigment)
NM Disease Concept - Abdominal - Estrogen Aureus...gold
- Restrictive Blood Gas - Pelvis Epidermidis...white
- pO2 CO2 pH Uses for Pilocarpine Saprophyticus..none
- RR Negative Stranded RNA - Cystic Fibrosis
- Risk for Seizures - 1-3 week prodromal period - Closed angle Glaucoma Strep. Pyogenes
- Pulmonary Capillary before SX -MCC: all throat infections,
Wedge pressure - Must switch to a positive Cause Dysguzia lymphangitis, impetigo,
stranded before it can - Metronidazole necrotizing faceitis, erysipelas,
PIE Syndrome replicate - Clarithromycin Scarlet fever
(Pulmonary Infiltrate with - Zinc deficiency - 2nd MCC: all other skin
Eosinophillia) Positive Stranded RNA infections
- Necator Americanus - Symptoms occur within 1 Carcinoid Triad
- Ascaris Lumbricoides week or less - Flushing Neutrophil Deficiencies
- Schistosomiasis - Don't have to switch before - Wheezing - Job-Buckley Syn.
- Strongyloides replicating - Diarrhea - NADPH Oxidase defic.
- Ankylostoma - Exceptions: Hanta, Ebola, and - Neutropenia
Yellow Fever which are **Dx by measuring 5-HIAA in - Myeloperoxidase defic.
Enzymes used by B12 Negative Stranded the urine**
- Methyl Malonyl CoA mutase Compartment Syndrome
- Homocystine methyl Cyanotic Heart Disease **Most common primary - Pain (always first)
transferase - Transposition of great location = appendix** - Pallor
arteries - Polkiothermia
Increased Susceptibility to - Tetralogy of Fallot ** Most common metastic - Parathesia
pseudomonas & S, aureus - Truncus Arteriosus location = pancreas, ileum** - Pulselessness (always last)
- Burn patients - Tricuspid Atresia
- Cystic Fibrosis - Total Anomalous Pulmonary AMVs Itchiest Rashes
- Diabetes Venous Return Machinery murmur - Scabies
- Neutropenics - Hypoplastic Left Heart - Heart: PDA - Lichen planus
Syndrome - Elbow: dialysis fistula - Urticaria
Crohn's Disease - Ebstein's Anomaly - Brain: Von Hippel-Lindau - Dermatitis herpetiformis
(GIFTS) - Aortic Atresia - Lungs: Osler-Weber-Rendu
- Granuloma - Pulmonic Atresia Oddities About Listeria
- Illeum Hemophilus Influenza - Only gram positive w/
- Fistula LL to Depolarize - Gram negative rods endotoxin
- Transmural - Hypermagnesemia - Pleomorphic - Crosses placenta
- Skip Lesions - Hypercalcemia (except - "School of Fish" - Lipid A is toxic part
atrium) - Type A = non-encapsulated, - Causes granulomas
Causes of Widened S2 - Hypokalemia non-invasive, MCC of sinusitis, - Causes sepsis in neonates
- pO2 - Hypernatremia otitis, bronchitis - Raw cabbage, spoiled milk
- volume Rt. Ventricle - Type B = encapsulated,
- Blood transfusion ML to Depolarize invasive, IgA protease, MCC
- Supplemental O2 - Hypomagnesemia of epiglottitis
- Rt. Sided heart failure - Hypercalcemia (except
- Pregnancy atrium) Rust Colored Sputum
- IV fluids - Hyperkalemia - Strep. Pneumoniae
- ASD (fixed) - Hyponatremia (aka pneumococcus)
- Deep breathing
B Vitamins Heart Block Clue 5 Causes of SIADH Types of Kidney Stones
B1 - Thiamine - Increased body temperature (SIADH) - Calcium oxalate - 80%
- Beriberi with a normal heart rate - Small Cell Carcinoma - Struvite
- Weirnickes - HR should increase by 10bpm - intracranial pressure - Uric Acid
- Korsacoff for every 1 degree increase in - A Pain - Cysteine
B2 - Riboflavin temperature - Drugs - Oxalate
- Angular stomalitis - Hypoxia
B3 - Niacin Macrophages Pseudogout
- Pellagra - Release MHC II Cells of Neutral Crest Origin - Ca++ pyrophosphate
- 4 d's (POT CLAMPS) - + birefringent crystals
B4 - Lipoic Acid TH1 Secrete - Parafollicular cells - Rhomboid crystals
B5 - Pantothenic acid - IL-2 - Odontoblast - MC older patients
B6 - Pyridoxine - IF- - Tracheal cartilage - Seen equally in both sexes
- Seizures - Chromaffin Cells - Tx = Colchicine
B9 - Folate TH2 Secrete - Laryngeal cartilage
B12 - Cobalamine - IL-4 - All Ganglion cells MC Non-cyanotic Congential
- Pernicious Anemia - IL-5 - Melanocytes Heart Disease
- Neuropathy - IL-6 - Pseudounipolar cells - VSD
- IL-10 - Spiral Membrane - ASD
Periods of Rapid Growth - PAD
- Birth - 2 months TH0 Secrete Ions and the EKG - Coarctation of aorta
- 4-7 years - TH1 P-wave = Ca++
- Puberty - TH2 QRS complex = Na+ Enzymes NEVER seen in
++
S-T Interval = Ca Glycolysis
Only Immune Deficiency with T-Cytotoxic Cells T-wave = K+ - Pyruvate carboxylase
Low Calcium - CD-8 positive U-wave = Na+ - PEP carboxykinase
- DiGeorge's Syndrome - CD-4 negative - Fructose-1, 6-phosphatase
- Recognize MHC I Maximum Sinus Rate - Glucose-6-phosphatase
Bugs with IgA Protease - Also have markers CD-2 and 220-age in years
- S. Pneumonia CD-3 Enzymes ONLY seen in
- H. Influenza Tri-Nucleotide Repeats Glycolysis
- Neisseria T-Helper Cells - Huntington's - Hexokinase
(are resistant to IgA) - CD-4 positive - Fragile X - Phosphofructokinase-1
- CD-8 negative - Myotonic dystrophy - Pyruvate kinase
Secretions of Mast Cells - Recognize MHC II - Spinal/bulbar muscular
- Histamine - Also have markers CD-2 and atrophy (rare) Acid Fast Organisms
- Slow reacting substance of CD-3 - Mycoplasma
Anaphylaxis Low volume states with - Norcardia (partially, gr+)
- Eosinophil chemotatic factor Elevated Cholesterol Acidosis (not alkalosis) - Cryptosporidium (partially,
of anaphylaxis - Xanthanthomas on - RTA protozoa)
extensor surfaces - Diarrhea
Secretions of Eosinophil - risk for CAD Microsteatosis Causes
- Histaminase MCC Croup & Bronchiolotis - Acetaminophen
- Arylsulfatase Elevated Triglycerides - Parainfluenza - Reye Syndrome
- Heparin - Xanthelasmas on eyelids and - RSV (ER this is #1) - Pregnancy
face - Adenovirus
Actions of E.coli - risk of Pancreatitis - Influenza Macrosteatosis Causes
- Secrete Vitamin K - Alcohol
- Secrete Biotin 4 causes of severe pain 4 D's of Pellagra
- Secrete Folate - Pancreatitis (EtOH) - Dermatitis Bacteria with Elastase
- Secrete Pantothenic acid - Kidney Stones (bloody urine) - Diarrhea - Staph. Aureus
- Aids in absorption of B12 - AAA (ripping, tearing, pain) - Dementia - Pseudomonas
- Ischemic Bowel (bloody - Death
diarrhea) Bacteria with toxins that
Inhbit EF-2
- Pseudomonas
- Diphtheria
Phage Medicated Toxins Gram Positive Spore Formers Group D Streptococcus MCC of Newborn Meningitis
(Oh BED) - Bacillus anthracis Viridans - green pigment - Group B Strep
- "O" antigen (Salmonella) - Clostridium perfrigens - SBE - E. coli
- Botulinum - Clostridium tetani Mutans - cavities - Listeria
- Erythrogenic toxin Sanguis
- Diphtheria Used for Cold Agglutinin Salivaris Bacteria Accociated with
Testing Bovis Colon Cancer
Segmented Viruses - Strep. Salivarius - C. melanogosepticus
(I sprayed ORTHO on BUNYA Nephritis Syndrome - S. bovis
at the ARENA down in REO to Drugs that Cause Disulfram - Hypertension
kill SEGMENTED worms) Reaction - Hematuria Gram - that are strict
- Orthovirdiae - Chlorpropamide - RBC Casts Anaerobes
- Bunyavirdiae - Lactams - H flu
- Arenavirdiae - Antabuse Nephrotic Syndrome - Neisseria
- Reovirdiae - Metranidazole - Edema
- Hyperlipidemia Pre-renal Failure
Functions of Adhesion 3 Toxins of Bacillus - Hypercholesterolemia Serum BUN > 20
Molecules - Lethal factor - Hypercoaulability Serum Cr > 40
- Lymphocytes homing - Protective factor - serum albumin Fractional Na exc. < 1%
- Inflammation - Edema factor - urine albumin
- Cell-cell interaction Renal Failure
Beta Blockers MCC of Airway Infection Serum BUN ~ 10 to 15
Esophageal/Gastric CA Risk B1 Selective: A-M (sinusitis, otitis, bronchitis, Serum Cr < 20
Factors (except C & L) pneumonia) Fractional Na exc. > 2%
- Smoking Nonselective: N-Z, C, L #1 - S. pneumonia
- Alcohol #2 - H. influenza Extravasation
- Nitrates Fanconi Syndrome #3 - N. meningitides - Pavementing
- Japanese - Defect in proximal tubule - Margination
- Can't reabsorb Gastroenteritis within 8 hours - Diapedesis
Bladder CA Risk Factors - Low energy state of eating - Migration
- Smoking - Can be caused by old (pre-formed toxin)
- Aniline dyes tetracycline - S. aureus (potato salads) If Cell Mediated is defective -
- Benzene - C. perfringens (holiday tx for
- Aflatoxin Glutaminase turkey/ham) - Viral
- Cyclophosphamide - In collecting duct - B. cereus (fried rice) - Fungal
- Schistosomiasis - Absorbs ammonia in liver - Mycobacterium
- Von Hippel-Lindau - Cause of hepato-renal Citrobacter - Protozoa
- Tubular Sclerosis syndrome - Cause of multiple cerebral - Parasite
abscesses in newborns - Neoplasm
Structures with no known 3 Anatomical Narrowings of
Function Ureter MCC of UTI Herpes Viruses
- Appendix - Hilum #1 - E. coli - I - oral
- Epithalamus - Pelvic Brim #2 - Proteus - II - genital
- Palmaris longus - Entrance of bladder #3 - Klebsiella - III - varicella zoster
- Pancreatic polypetide - IV - EBV
Old MCC of Death Most frequent in Females 5-10 - V - CMV
Progressing to RPGN SLE, endrometrial and cervical and 18-24 years - VI - Roseola
- Goodpasture's (#1) cancer - renal failure - S. saprophyticus b/c they - VII - Pityriasis rosea
- Diabetes Melitis stick things inside themselves - VIII - Kaposi's
- Hypertension Methotrexate Uses
- Wagener's - Dx Fragile X S. aureus Disease Picked up during
- Tx Molar Pregnancy - MCC of osteomyelitis Delivery
Causes of Papillary Necrosis - Tx Fast growing CA - MCC of infection in burn - Group B Strep
- Vasculities - Tx Steroid resistant disease patients - S. pneumonia
- AIDS - Herpes
- N. gonorrhea
- Chlamydia
T&B Cell Deficiencies Amino Acid Abbreviations
- WAS - Thrombocytopenia, IL-4, Eczema, IgM Glycine Gly Threonine Thr
- SCID - Adenosine deaminase deficiency, T>B, frameshift/ Alanine Ala Cysteine Cys
nonsense mutation, bacterial & fungal infx. Valine Val Tyrosine Tyr
- CVID - Tyrosine kinase deficiency, Late onset, frameshift/ Leucine Leu Asparagine Asn
nonsense mutation Isoleucine Iso Glutamine Gln
- HIV (HTLV-1) - Effects CD-4 rich tissues (brain, testicles, Methionine Met Aspartic Acid Asp
cervix, rectum, blood vessels), T>B Phenylalanine Phe Glutamic Acid Glu
- Job-Buckley Syndrome - red headed female, Tyrosine kinase Tryptophan Trp Lysine Lys
deficiency Proline Pro Arginine Arg
Serine Ser Histidine His
B-Cell Deficiencies
- Bruton's Agammaglobulinemia - Tyrosine kinase deficiency Amino Acid Subgroups
- Leukemias - Acidic: Asp Glu
- Lymphomas - Basic: Arg Lys
- See above for those with T-cell overlap - Sulfur Bonds: Cys Met
- O-Bonds: Ser Thr Trp
T-Cell Deficiencies - N-Bonds: Asp Gln
- DiGeorge's - hypokalemia, problem with 3rd and 4th - Branched: Leu Iso Val
pharyngeal pouches, deletion of chromosome 22 - Bulky (Aromatic): Phe Thr Trp
- HIV - Smallest: Gly
- See above for those with B-cell overlap - Responsible for Bends: Pro
- Ketogenic: Lys Leu
Electron Transport Chain - Gluco-& Ketogenic: Phe Iso Thr Trp
- Poisons - Glucogenic: His Arg Glu Asp Gln
Complex I .. Amytal, Rotenone Asn Tyr Cys Pro Met
Complex II . Malonate Val Ala Gly
Complex III Antimycin
Complex IV CN, CO, Chloramphenicol Essential Amino Acids
Complex V . Oligomycin (PVT TIM HALL)
- Chemical Uncouplers Phe Trp His
DNP Val Iso Arg
Free Fatty Acids Thr Met Leu
- Physical Uncouplers Lys
Aspirin ****If there is a deficiency in Phe then Tyr becomes essential
(like in PKU). If there is a deficiency in Met then Cys becomes
Places where Amino Acids feed in/out of TCA Cycle essential ****
- Pyruvate . Gly, Ala, Ser
- Acetyl CoA ... Phe, Iso, Thr, Tyr, Lys, Leu Restriction Enzymes
- -ketogluterate Glu, Gln (Cut to the right unless otherwise specified)
- Succinyl CoA Phe, Trp, Tyr Trypsin ... Arg, Lys
- Fumerate Pro Chymotrypsin ..... Phe, Tyr, Trp
- Oxaloacetate .. Asp, Asn Elastase .... Gly, Ser, Ala
Mercaptoethanol .. Met, Cys
Amino Acid Deficiencies Aminopeptidase ... Amino terminal
- PKU - Phenylalanine hydroxylase deficiency, needed to Carboxypeptidase .... Left of carboxy terminal
make tyrosine, leads to a lack of Dopamine, Epi and Norepi, Cyanobromide .... Met
melanin
- Maple Syrup Urine Disease - deficiency in branched amino
acids (Leu, Lys, Val), defective transport in the kidneys
- Cystinuria - Cystathione synthase deficiency; cysteine,
ornithine, lysine and Arginine end up in urine, stones
2nd Messengers Co-factors for Pyruvate DH, -ketogluterate DH & Branched
cAMP .. Sympathetic, catabolic, CRH Chain DH
cGMP .. Parasympathetic, anabolic (TLC For Nanna)
IP3/DAG .. Smooth muscle contraction by horn./NT - TPP . Thiamin (B1)
.. All hypothalamic hormones (except CRH) - Lipoic Acid .. B4
Ca:Calmodulin . Smooth muscle contraction by distention - CoA ... Pantothentic Acid (B5)
Ca++ .. Gastrin - FAD ..... Riboflavin (B2)
Tyrosine Kinase . Insulin and all growth factors - NAD ... Niacin (B3)
NO .. Nitrates, Viagara, ANP, and LPS
Diseases with X-linked Inheritance
Autoimmune Antibodies Recessive
Disease Anti- - Burton's Agammaglobulinemia
- Smith - CGD (NADPH Oxidase deficiency)
SLE - Double stranded DNA - Duchenne's Muscular Dystrophy
- Cardiolipin - Colour Blindness
Drug Induced SLE - Histone - Hemophilia
Progressive Systemic Sclerosis - Topoisonmerase - G6PD
Graves - TSH Receptor - Lesch-Nyhan
CREST - Centromere - Pyruvate DH deficiency
- Glomerular Basement - Fabry's
Goodpasture's Membrane - Hunter's
- (aka Type IV Collagen) Dominant
Primary Biliary Cirrhosis - Mitochondria - Huntington's
Alopecia Areata - Hair follicle - Vitamin D resistant Rickets
Rheumatoid Arthritis - IgG
Multiple Sclerosis - Myelin Receptors Nephrotic Patterns of Vasculitis
Celiac Sprue - Gliaden/gluten Renal Artery Stenosis . Clot in front of renal artery
Type I Diabetes - Islet cell receptor Renal Failure Clot off entire renal artery
Vitiligo - Melanocyte GN ... Inflamed glomeruli
Myathenia Gravis - Acetylcholine receptor Papillary Necrosis .. Clot in papilla
- Ribonuclear protein Interstitial Nephritis .... Clot of medula
Mixed Connective Tissue Disease
Focal Segmental GN ... Clot off pieces of nephron
- Partial cell receptor Rapidly Progressive GN ... Clot off lots of nephrons
Pernicious anemia
- (aka. Intrinsic factor)
- Epidermal anchoring protein MC Nephrotic Disease in Adults .... Membranous GN
receptor MC Renal Dis. In Blacks/Hispanics .. Focal Segmental GN
Pemphigus vulgaris
- (aka. Intracellular junctions of MC Renal Disease in HIV/drug users . Focal Segmental GN
epidermal cells) MC Renal Mass .. Cyst
Bullous pemphigold - Epidermal basement membrane MC Malignant Renal tumor in adults .. Adenocarcinoma
- Thyroglobulin MC Malignant Renal tumor in kids .. Wilm's tumor
Hashimoto's
- Microsomal
- Smooth muscle MCC of Rapidly Progressive GN .... Goodpasture's
Scleroderma
- SCL-70 MC Nephrotic Disease in Kids .... Minimal Change Disease
- Rho
- La ***RPGN - crescent formations
Sjogren's - SSA ***Minimal Change Disease - 2 weeks post URI
- SSB
- Proteinase Thrombolytics and Rescues
Wegener's
- C-ANCA - tPa Amioncaproic acid
Polyarteritis Nodosa - P-ANCA - Streptokinase . Amioncaproic acid
- Platelet - Warfarin ..... Vitamin K
Idiopathic Thrombocytic Purpura - (aka glycoprotein IIb/IIIa) - Heparin .... Protamine Sulfate

If active hemorrhage give Fresh Frozen Plasma (FFP)


Rashes Associated with Cancer Lipoprotein Transport
- Urticaria (hives) ... any, but especially lymphoma - Chylomicrons: takes triglycerides from GI to liver &
- Paget's Disease .... Intraductal carcinoma endothelium
- Seborrheic keratosis .... Colon cancer (HIV is sudden ) - VLDL: takes triglycerides from liver to adipose
- Actinic keratosis . Squamous cell carcinoma of skin - IDL: takes triglycerides from adipose to tissue
- Dermatomyositis (heliotropic, malar) .... Colon cancer - LDL: only one to carry cholesterol
- Akanthosis nigricans ... Visceral CA & end organ damage - VLDL: only made in the liver
- Erythema nodosum granulomatous (nonbacterial) - IDL + LDL: break down products of VLDL

Cancer Grading - severity of microscopic changes Meningitis (MCC)


0 months - 2 months .. Group B strep
Cancer Staging - Degree of dissemination of tumor .. E. coli
.. Listeria
Tumor Markers/Oncogenes 2 months - 10 years .. S. pneumoniae
.. Neisseria meningitides
l-mye Small cell carcinoma of the lung 10 years - 21 years .. Neisseria meningitides
c-myc Burkitt's Lymphoma Over 21 years .. S. pneumoniae
n-myc Neuroblastoma
c-abl CML, ALL Indications for Pneumovax
c-myb Colon, AML - Covers MC 23 strains
- Given at 2, 4, and 6 months
c-sis Osteosarcoma, glioma, fibroscarcoma - Given to anyone over 65 years old
ret MEN II, MEN III - Anyone who is asplenic
k-ras Lung, Colon - Anyone with end organ damage (CF, RF, Nephrotic)
Follicular lymphoma (can show up in Burkitts - pick follicular
bel-2 first HIV
Most common infection ... CMV
Rb Retinoblastoma Most common cause of death . PCP
CEA Colon, Pancreas p41 .. just a surface marker
S-100 Melanoma GP120 .... Attachment to CD4
HER-II, Breast Pol ... transcription
Neu, Reverse transcriptase ... integration
p17 and p24 antigens .... Assembly
Translocations
9:22 Philadelphia Chromosome (CML) Normal CD4 count: 800-1200 in adults (up to 1500 in kids)
8:14 Burkitt's Lymphoma <500: begin treatment with 2 nucleotide inhibitors and 1
14:18 Follicular Lymphoma protease inhibitor (750 in kids)
15:17 Promyelblastic leukemia <200: is AIDS, add treatment for PCP
11:14 Mantle Cell Lymphoma <100: add treatment for MAC
11:22 Ewing's Sarcoma
17:22 Neurofibromatosis Characteristics of Autosomal Dominant Inheritance
- Affects males and females equally
Enzymes Needed to Make Glycogen - Manifests in heterozygous state
- Glycogen synthase - Can be transmitted by either parent
- Branching enzymes - Often delayed onset (adult dx)
glycogen -1, 4 glycosyl transferase - Vertical transmission
glycogen -1, 6 glycosyl transferase - New mutations occur in germ cells of older fathers
- Can exhibit reduced penetrance & variable expressivity
Enzymes Needed to Break Down Glycogen - Usually structural defects
- Phosphorylase
- Debranching enzyme Characteristics of Autosomal Recessive Inheritance
- A-1, 6-Glucosidase - Disease usually does not affect parents
- Phosphatase - Disease may be seen in siblings and uncles
- Often early onset (early dx)
- Disease only present when both alleles are mutant
- Horizontal transmission
- Usually enzyme defects (inborn errors of metabolism)
Characteristics of Mitochondrial Inheritance Oxalate Stones
- All females will pass on the disease - In 3 year old white female - Cystic Fibrosis
- No males will pass on the disease - In 5 year old black female - Celiac Sprue
- All offspring of affected females will be affected - In adult female - Whipple's Disease
- Often affects CNS, heart, and skeletal muscle - In adult male or female - Crohn's Disease
- Due to uneven cytokinesis during meiosis/oogenesis
Pituitary Hormones
Immune System Timeline Anterior:
<24 hours -> swelling GH
Acidophilic
At 24 hours -> neutrophils show up Prolactin
Day 3 -> neutrophils peak
Day 4 -> T-cells and M show up TSH
Day 7 -> Fibroblasts show up ACTH
Basophilic
1 month -> Fibroblasts peak LH
3-6 months -> Fibroblasts are gone FSH
Posterior: ADH (supraoptic nucleus)
Mitochondrial Diseases Oxytocin (paraventricular nucleus)
Leigh's Disease: subacute necrotizing encephalopmyelopathy,
progressive IQ, seizures, ataxia, cytochrome oxidase Sub-Acute Bacterial Endocarditis
deficiency - MC bacteria is Strep. Veridans
Leber's disease: hereditary optic atrophy - Roth Spots
- Janeway lesions (toes)
Tx for Hypercholesterolmia - Osler's nodes (fingers)
Stains: - Splinter hemorrahes
P - Provostatin (only one renally excreted) - Endocarditis
A - Atorvastatin Liver enzyme - Mycotic aneurysm (septic emboli)
L - Lovastatin every
S - Simvastatin 3 months Emphysema Types
Bullous .. Due to #1 = Staph. Aureus
MoA: Inhibit HMG CoA reductase .. Due to #2 = Pseudomonas
Most active around 8 pm Centroacinar . Due to smoking
Must take at night for max efficiency Distalacinar Due to normal aging
Panacinar Due to 1 - antitrypsin deficiency
Atrial Action Potential
Phase 0 - depolarization Erythropoiesis
Phase 1 - No name 4 months gestation .. Yolk Sac
Phase 2 - Plateau (A-V Node) 6 months gestation .. Spleen, liver, flat bones
Phase 3 - Repolarization 8 months gestation .. Long bones
Phase 4 - Automaticity (S-A Node) 1 year of age .. Long bones

Pneumonia (MCC) **If long bones become damages the spleen can take over,
6 weeks - 18 years RSV (infants only) resulting in splenomegaly**
Mycoplasma
Chlamydia pneumonia Diphtheria
Strep. Pneumonia - It's toxin ADP ribosylated EF-2
18 years - 40 years Mycoplasma - Stops cell synthesis
Chlamydia pneumonia - Gram positive
Strep. Pneumonia - Acquired exotoxin from a virus via transduction
40 years - 65 years Strep. Pneumonia - Causes heart block
H. influenza - Never scrape the membrane b/c it is highly vasular so it will
Anaerobes bleed and also release toxin
Viruses
Mycoplasma Cystic Fibrosis
Elderly Strep. Pneumonia - Sweat test: >60 - definitive positive
Viruses <20 - normal
Anaerobes 30-60 - Heterozygous
H. influenza
Gram negative rods
Inclusion Bodies Chelaytors
Howell-Jolly.
Sickle Cell Methylene Blue - Methemaglobinemia
Heinz.
G-6-PD Sodium Thiosulfate - Cyanide
Zebra.
Niemann Pick CaEDTA - Lead (to test)
Donovan..
Leishmaniasis Penicillamine - Lead (in plasma)
Mallory.
Alcoholism Dimeraprol - Lead (in bone marrow)
Negri..
Rabies
Councilman..
Yellow Fever **Tx for cyanide poisoning
Call-Exner..
Ovarian tumors - Amyl nitrate
Lewy..
Parkinsons - Sodium thiosulfate
Pick.
Pick's Disease - Methylene Blue
Barr Bodies
Female - Transfusion
Aschoff.
Rheumatic Fever
Cowdry Type A..
Herpes Renal Tubular Acidosis (acidosis & hypokalemia)
Auer Rods..
AML Type I High urine pH
Globoid
Krabbe's Disease Acidosis
Russell.
Multiple myeloma Frequent UTI
Schiller-Duvall
Yolk Sac tumor Stones
Basal Bodies.
Smooth Muscle Babies die <1 year
Type II Low urine pH (2)
Allergic Response Hypokalemia
Primary - CONTACT NO carbonic anhydrase
- Neutrophils work in the first 3 days Type III Combo of Type I and II
- Then B-cells produce IgM Normal urine pH
Shows up at 3 days Hypokalemia
Peaks at 14 days Type IV Diabetics
Gone in 2 months Hyperkalemia
- IgG NO aldosterone (Infarcted
Show up at 2 weeks JG apparatus)
Peaks in 2 months
Gone in 1 year Hemolytic Properties of Streptococcus
Secondary - MEMORY - partial hemolysis Green zone
- IgG shows up at day 3 with 5x the concentration - complete hemolysis Clear zone
Highest affinity for antigen - No hemolysis Red zone
Peaks in 5 years
Stays for 10 years Transduction
Bacteria becomes deadly when a virus injects its DNA
Amyloidosis
AL Portion homologous with Ig Light Primary amyloidosis, Transformation
Chain multiple myeloma In a hospital or nursing home the bacteria has
AA Unique N-terminal sequence Chronic Active disease, become deadly by this mechanism
Hodgkin's disease
Pre-albumin/ Single amino acid substitution Hereditary neuropathy, Conjugation
transthyretin nephropathy and Only occurs if bacteria has PILI
cardiopathy
AB B2 microglobin Cerebral artery amyloid, Coumadin vs. Heparin
Alzheimers, Downs Extrinsic Intrinsic
AE Endocrine Aging Tissue Blood
AP Universally associated with all amyloids PT PTT
Factors 2, 7, 9, 10 Factor 3
p.o. i.v.
8-10 hrs delay immediate
C/I in preg. OK in preg
Inhibit Vit K dependant DOC for DVT
factor

(Keep the PeT out side - extrinsic)


(PeT is Cujo who bites - p.o.)
RASHES
Erythrma marginatum small red spots with bright red margins, sand papery, Rheumatic fever
Erythrma chronicum migraines target lesion, bullseye, Lyme disease
Measles morbiliform rash, preceded by cough and conjunctivitis
Roseola fever for 2 days then rash pops up (rash only after fever is gone), HHV 6
Erythema nodosum tender nodules and redness on the anterior aspect of the legs
red macules, target lesions, allergy and viruses
- Mild - most common cause is viral (2nd is drugs)
Erythema multiforme
- Moderate - Stevens Johnson Syndrome
- Severe - Toxic Epidermal Necrolysis
Seborrheic dermatitis scaly skin with oily skin on the hairline
Seborrheic keratosis stuck on wart appearance
Psoriasis silvery white plaques on extensor surfaces, scaly skin, pitted nails
Varicella Zoster red macules, papules, vesicles, pustules then scabs: different stages at same time, HHV 3
Dermatitis herpetiformis rash/blisters on anterior thigh, associated with diarrhea due to Celiac Sprue flare up
Typhoid fever rose spots associated with "intestinal fire", Salmonella Typhi
Dermatomyositis heliotropic rash
Erysipelas reddened area with raised borders, does not blanch
Tinea cruris redness, itchy groin
Pityriasis rosea herald patch: dry skin patched that follows skin lines, HHV 7
Tinea versicolor hypo-pigmented macules on the upper back in a "V" pattern
Scabies linear excoriation on belt line and finger webs

Hepatitis B
Incubation: 4-26 weeks (8 wk average)
Acute Disease: 4-12 weeks
Convalescence: 4-20 weeks
Recovery: Years

Acute recent infection HBcAg+, HBsAg+, (HBcAb+/-)


Recent immunization (within pervious
HBsAg+ only
2 weeks)
Immunization (more than 2 weeks) HBsAb+ only
Previous infection, now immune HBcAb+, HBsAb+, HBsAg-
Infectious HBeAg+
Non-infectious HBeAg-
Chronic carrier HBsAg+ for more than 6 months (HBsAb+/-)
Window period HBeAb+, HBcAb+, HBsAg-
HLA Markers Diseases Pneumonic
DR-2 Narcolepsy, Allergy, Goodpasture, MS 2 Itchy Sheep (Mary and Sarah), Sleep in a Goodpasture
DR-3 Sjogren's, SLE, Celiac Sprue, Chronic Active Hepatitis 3 S's and Chronic Active Hepatitis
DR-3 & 4 IDDM Type I
DR-4 Rheumatoid Arthritis, Pemphigus vulgaris RAP
DR-5 Juvenile Rheumatoid Arthritis, Pernicious Anemia JRAP
DR-7 Steroid Induced Nephrotic Syndrome
DR-3 & B-8 Celiac Disease
A-3 Hemochromotosis
B-8 Myathenia Gravis
B-13 Psoriasis w/o arthritis
B-27 Psoriasis w/ arthritis, Ankylosing Spondylitis, IBD, 2PAIR
Reiter's, Postgonococcal arthritis
BW-47 21--Hydroxylase deficiency (Vitamin D)

Immunoglobulins
- Monomer in the blood
IgA - Dimer in secretions
- Protects the mucoscal surfaces and body secretions
IgD - Only known for function is as a surface marker on mature B-cells
- Mediator of Type I hypersensitivity (anaphylaxis)
- Parasite defense
IgE - Responsible for allergies
- Fc portion binds to mast cells and basophils
- Does not fix complement
- Second to be produced during the primary immune response
- Only one to be produced during the secondary immune response
- In memory (secondary) response
Shows up at 3 days with 5x the concentration of primary response
Peaks around 5 years
IgG Some remain in circulation for 10 years
- Has 4 subclasses (antigenic differences in heavy chains and with disulfide bonds)
IgG1 - crosses the placenta due to Fc portion
IgG2 - most common deficiency, susceptible to encapsulated organisms
IgG3 - most memory antibodies
IgG4 - Only one that does not fix complement
- Present only in the primary immune response
IgM - Most effective in agglutination and complement fixation
- Defense against bacteria and viruses

Hyperlipidemias
Type Deficiency Component Misc Information
I Lipoprotein Lipase - defect of the liver type only Chylomicrons
II Receptor or receptor enzyme - IIA, IIB, or B100 LDL Most common in general pop.
III APO E receptor IDL
IV Lipoprotein Lipase - defect of the adipose type only VLDL
V Enzyme and receptor defect - APO CII Chylomicrons & VLDL Associated w/ diabetes melitis
Interleukins and Other Inflammatory Mediators
- Secreted by macrophages
IL-1 - Causes fever and other non-specific symptoms of illness
- Recruits Thelper cells
- Secreted by T cells
- Most potent
IL-2
- Most powerful Chemotactic factor (recruits everyone)
- Must be inactivated prior to transplantation
- Secreted by T cells
IL-3 - Causes B cell proliferation
- Labelled by Thymidine
- Secreted by T cells
IL-4 - Causes B cell differentiation
- Responsible for class switching to IgG and IgE
- Secreted by T cells
IL-5
- Responsible for class switching to IgA
IL-8 - Neutrophil Chemotactic factor
- Suppresses cell mediated response
IL-10
- Tells macrophages and T-cells to stay away if there is a bacterial infection
- Promotes cell mediated response
- If infection in non-bacterial it is released to recruit macrophages and T cells
IL-12 - Activates NK cells to secrete IF-
- Inhibits IL-4 induced IgE secretions
- Changes TH cells into TH1 cells
- Secreted by Leukocytes
- Inhibits viral replication and tumor growth
IF- - Increases NK activity
- Increases MHC (class I and II) expression
- Interferes with protein synthesis
- Secreted by fibroblast
- Inhibits viral replication and tumor growth
IF- - Increases NK activity
- Increases MHC (class I and II) expression
- Interferes with protein synthesis
- Secreted by T-cells and NK cells
- Increases NK activity
- Increases MHC (class I and II) activity
IF-
- Increases macrophage activity
- Co-stimulates B-cell growth and differentiation
- Decreases IgE secretion
- aka Cachectin
- Secreted by monocytes and macrophages
- Induces IL-1
TNF- - Increases adhesion molecules and MHC class I on endothelial cells
- Is a pyogen
- Induces secretion IF-
- Cytotoxic/cytostatic
- aka Lymphotoxin
TNF- - Secreted by T-cells
- Cytotoxic
- Secreted by solid tumors (carcinoma<sarcoma) and monocytes
TGF-
- Induces angiogenesis, keratinocyte proliferation, bone resporption, and tumor growth
- Secreted by platelets, placenta, kidney, bone, T-cells and B-cells
- Induces fibroblast proliferation, collagen synthesis and fibronectin synthesis
TGF-
- Inhibits NK, Lymphokine Activated Killer Cells, Cytotoxic T Lymphocytes, T cell and B cell proliferation
- Enhances wound healing and angiogenesis
**IL = Interleukin** **IF = Interferon** **TNF = Tumor Necrosis Factor** **TGF = Transforming Growth Factor**
EKG Breakdown
Portion of EKG Portion of Heart Phase of Action Potential
P-wave Atrium 0
P-R interval AV Node 2
Q-wave Septum 2
R-upstroke Anterior wall 2
S-downside Posterior wall 2
S-T interval Ventricle 2
T-wave Ventricle 3
U-wave Ventricle 4

Adhesion Molecules
- Homing of lymph nodes to site of inflammation
ICAM-1, ICAL-2, ICAM-3
- Found on T-cells, endothelial cells, dendritic cells
IgCAM - Mediate T-cell interactions BINDING PROTEINS
LFA-3
- Found on lymphocytes, APC
LFA-2 (CD2) - Found on T-cells, NK cells
- Migration thru extracellular matrix
VLA-1 (1)
- Widely distributed
- Tight binding to endothelium
LFA-1 (2)
- Found on lymphocytes
- Tight binding to epithelium
Integrins STOPS THE LEUKOCYTES
- Phagocytosis
CR3 (2)
- Mac-1
- CD11/CD18
- Phagocytosis
CR4 (2)
- Opsonin receptor
- Leukocyte migration and homing
E-selectins
- Found on activated endothelium
BIND CARBOHYDRATES
- Initial binding to endothelium
Selectins L-selectins MEDIATES "ROLLING"
- Found on leukocytes
(slows leukocytes)
- Leukocyte migration to inflammatory sites
P-selectins
- Found on activated endothelium and platelets

Hypersensitivities
(ACID)
Type I - Anaphylaxis
IgE binds to mast cells - degranulates mast cells
IgA activates IP3 cascade - degrades mast cells
Type II - Cytotoxic (humoral) - Goodpasture, Autoimmune hemolytic anemia
Type III - Immune Complex mediated - Rheumatoid arthritis, SLE
Type IV - Delayed (cell mediated) - TB skin test, contact dermatitis, transplant rejection
Mechanisms of Actions
Drug Mechanism
5FU Inhibits thymidylate
Methotrexate Inhibits dihydrofolate reductase
Hydroxyurea Inhibits ribonucleotide reductase
Vincristine/Vinblastin Inhibit microtubule formation
Paclitaxel Inhibits microtubules from migrating
Levamisole Stimulates Natural Killer (NK) cells
1. Kills T-cell and Eosinophils
2. Inhibits macrophage migration
Steroids 3. Inhibits phospholipase A
4. Inhibits mast cell degranulation
5. Stabilizes endothelium
Statins Inhibit HMG CoA reductase
Niacin Decreases VLDL production in the liver
1st generation - Block potassium channels in the islet cells preventing insulin release
Sulfonylureas
2nd generation - Promote insulin release and inhibit gluconeogenesis in the liver
Miglitol/Ascarbose Inhibit glucose absorption from the GI
Metformin Stops gluconeogenesis in the liver
Troglitazone Increases the sensitivity of insulin receptors
Anti-psychotics Block dopamine receptors
Aspirin Irreversible inhibitor of cyclo-oxygenase
K+ Sparing Diruetics Competitive aldosterone receptor antagonist
+
Topical Anesthetics Block Na channels
Quinalones Block topoisomerase (supercoils)
Aminoglycosides Blocks Initiation Factor (IF) 2 on the 30S subunit
Tetracyclines Blocks tRNA binding on the 30S subunit
Rifampin Blocks beta subunit of RNA polymerase
Sulfa Drugs Blocks Para-Amino Benzoic Acid (PABA)
Cephalosporins Inhibit the cell wall
Penicillins Block transpeptidase
Chloramphenicol Blocks peptidyl transferase on the 50s subunit
Clindamycin/Lincomycin Blocks translocase on the 50s subunit
Macrolides Blocks translocase on the 50s subunit
Mitronidazole Increases production of free radicals
Vancomycin Blocks cell wall (phopholipid)
Benzodiazepine Increase the frequency of the GABA receptors via C1 channels
Barbituates Increase the duration of the GABA channels via C1 channels
TCAs Block reuptake of catacholamines, AV conduction and alpha receptors
SSRIs Block reuptake of Serotonin
MAOIs Inhibit MAO
Lithium MOA is unknown but is suspected to be related to it mimicking of Na+
Valproic Acid Blocks Na+ and sometimes Ca2+
Carbamizapine Blocks Na+ and Ca2+
Epinephrine Blocks Beta (2>1) receptors and the Alpha receptors
1st generation - blocks H1 and H2 receptors (H1>H2)
Antihistimines 2nd generation - blocks H2 only

Decongestants Alpha agonists


Antibiotic Coverage
Gram+ & Simple Gram- All Gram & 1
Gram+ 3 Atypicals Anaerobes Richetisia Other
S.aureus only pseudomonas
Quinolones X X X
Aminoglysides X
Tetracyclines X X X X
Cephalosporins X X X2
2
Penicillins X X
Macrolides X X X
Sulfa Drugs X X
Chloramphenicol X X X
Clindamycin X X X
Vancomycin X X *
Mitronidazole X **
Rifampin ***

1
Includes Chlamydia, Mycoplasma, ureaplasma, and legionella
2
Simple only (no "Big Mama")
3
H. Flu (not B) and E.coli
* Pseudomembranous colitis, MRSA, and enterococcis
** Protozoa
*** TB