Going Viral
1) ______ is the most common cause of febrile seizures in children. 2) This illness is caused by which herpesviruses?
1) Roseola
2) HHV-6 (more common), HHV-7
Source: Dr. Mariani & Anking
If __________ (antiviral used for RSV pneumonia) is used in its inhaler form, pregnant people or people wishing to become pregnant should not enter.
Ribavirin
Source: Dr. Mariani & Anking
1) What are Auer Rods, and 2) what are they suggestive of?
1)Myeloperoxidase (MPO) inclusions/aggregates
2) AML (more specifically APL) - *Sometimes rarely CML*
Source: Anking
When trying to differentiate T-ALL from B-ALL, what lab should you order?
Flow cytometry for surface markers:
- T-ALL -> CD2-CD8+
- B-ALL -> CD10+ and up!
*Both should be TdT+*
Source: First Aid
Allergic bronchopulmonary aspergillosis is a type ___ hypersensitivity reaction that may be treated with ______.
1) type I hypersensitivity
2) corticosteroids
Source: Anking
Narrowing of the trachea and subglottic region are known as the "______" sign with visualization of a chest X-ray, which is characteristic of which viral illness?
1) Steeple sign
2) Croup (parainfluenza)
- The "thumbprint" sign involves the epiglottis and is characteristic of H. influenzae infx.
Source: Anking
Acyclovir and Valacyclovir are common anti-virals. 1) Why should they be avoided in treating infectious mononucleosis? 2) What are some other pharmacological agents that would be more appropriate?
1) CMV and EBV lack thymidine kinase to phosphorylate acyclovir, rendering it still in its pro-drug (inactive) form.
2) Ganciclovir or valganciclovir are common therapeutics. Foscarnet or cidofovir are available for ganciclovir-resistant CMV.
Source: Anking
Most systemic fungi are dimorphic: "mold in the cold (soil) and yeast in the heat (human body."
There is one exception: ________, which is found in what form in the body?
1) Coccidiodoidies
2) Found in thick walled spherules of endospores
Source: Anking
If infectious mononucleosis is suspected, how can you distinguish between possible infectious agents?
1) Monospot test (tests for IgM heterophile antibodies). Will be positive in EBV, therefore a negative result may be suggestive of CMV. (The monospot test is a screening test). Definitive diagnosis of EBV is achieved through testing for EBV viral capsid antigen.
2) EBV is latent in B cells. CMV is latent in mononuclear cells (T cells, B cells, & macrophages).
3) EBV is HHV-4 & associated with splenomegaly. CMV is HHV-5 & associated with owl eye inclusions.
*Atypical lymphocytes can be either CMV or EBV*
Source: Anking
Y. pestis, E. coli, Salmonella, Listeria, Vibrio vulnificus, and many others bacteria are considered siderophilic. This translates to people with _________ being more commonly infected.
Source: Anking
Parvovirus B19 commonly causes aplastic crisis in what three conditions?
1) Sickle cell disease
2) Thalassemias
3) Hereditary spherocytosis
*These are all hemoglobinopathies!*
(Effect is transient and remits with resolution of the illness)
Source: Anking
Name 3 drugs that can induce aplastic anemia
NSAIDs, chloramphenicol, carbamazepine, beta-lactams, many many more.
- Just a reminder if these show up in pt history!
Source: Anking
_________ are eosinophilic intranuclear inclusions found in cells infected with organisms of the herpesviridae family.
Cowdry bodies
Source: Anking
Disorders of primary hemostasis versus secondary hemostasis have different patterns with clinical presentation in regards to bruising. Describe them.
- Primary (platelet) -> typically superficial/mucosal (petechiae or purpura) &/or quick onset of bleeding
- Secondary (factor) -> typically deep bleeding within joints or muscle & onset of bleeding takes ~1hr or more
*These are very general rules*
Source: Anking and Dr. Maliske.
Which immunodeficiency is ALWAYS caused by failure to repair DNA double-stranded breaks?
Ataxia-telangiectasia
Source: Anking
Why is there not a vaccine for Hepatitis C? Be specific.
Hep C virus displays antigenic variability of its envelope proteins.
- It lacks 3'-5' exonuclease activity -> no proofreading ability -> variation in antigenic structures of HCV envelope proteins
Source: Anking
Hydroxyurea is used in the treatment of hematogenous malignancies, particularly myeloproliferative disorders. 1) Specifically, ________ & _______ (myeloproliferative disorders)
2) Name an additional hematologic condition that hydroxyurea may be used to treat.
1) Chronic myeloid leukemia & polycythemia vera
2) Sickle cell disease, thalassemias, etc
Source: Anking
A lymph node biopsy of cat scratch disease will reveal _____________, resembling those seen in ______.
1) "Stellate granulomas"
2) Sarcoidosis
Source: Anking
Histopathological examination of Bartonella henselae reveals that it mimics the gross appearance of HHV-8. How can you tell these two infectious diseases apart?
1) HHV-8 (Kaposi sarcoma) -> lymphocytic infiltrate with plasma cells cause its VIRAL
2) B. henselae (cat scratch disease) (May be referred to bacillary angiomatosis). -> reveals neutrophilic infiltrate cause its BACTERIAL
*don't let these scary words throw you off from what you know <3*
Source: Anking
For an antithrombotic effect, it is best that the medication suppresses factor (s)_______.
For an anticoagulant effect, suppression mostly involves a decrease in factor(s) ________.
1) Antithrombotic -> factor II (and maybe also X)
- factor II IS thrombin. remembering this makes its easy! (Common coag cascade)
2) Anticoagulant -> factor VII
- targets extrinsic coag cascade
Source: Dr. Claren's lecture
Porphyria cutanea tarda is associated with which virus?
Hepatitis C!
Source: Dr. Mariani & Anking
What is the mechanism in which oral contraceptive pills increase risk for DVTs?
Estrogen in them decreases protein S levels and increases resistance to protein C.
Source: Anking
Visualization of keratinocyte apoptosis is suggestive of _________.
Graft versus host disease
Source: Dr. Somji's practice questions
Other than basophils being present with chronic myeloid leukemia, how can CML be distinguished from a leukemoid reaction?
Bone marrow:
- CML shows increased immature cells, low LAP score
- leukemoid rx shows normal/hypercellular with increased bands/early mature neutrophil precursors, high LAP (leukocyte alkaline phosphatase) score
(LAP is also high in polycythemia vera btw)
Source: Anking
What is the most likely cause of increased PT/PTT following low PO intake and antibiotic use in a patient with cirrhosis?
Vitamin K deficiency!
- Cirrhosis -> no storage of Vitamin K
- Abx -> no endogenous bacterial production of Vitamin K
- low PO intake -> no exogenous Vitamin K
Source: Anking