Enter Title

bilirubin & jaundice

100

The complete absence of UDP-glucuronosyltransferase (UGT1A1) is characteristic of which syndrome? Bonus: what type of bilirubin problem does it lead to?

Crigler-Najjar syndrome

Unconjugated hyperbilirubinemia

200

This enzyme catalyzed the conversion of heme to biliverdin during heme degradation. Bonus: where does this happen?

Heme oxygenase

Spleen

300

Should there be concern if a 16-hour old infant has jaundice?

Yes (<24 hrs old is cause for concern)

400

Biliary atresia would lead to (conjugated/unconjugated) hyper/hypobilirubinemia

Conjugated hyperbilirubinemia

500

Explain how kernicterus occurs

Prolonged neonatal jaundice leads to kernicterus/bilirubin encephalopathy because unconjugated bilirubin is lipid-soluble and can cross the BBB, build up in the brain and cause neurological damage

pertussis & RSV

100

List and briefly describe the 3 stages of a typical Bordatella pertussis infection

Catarrhal - pt is highly contagious, has general nonspecific URI symptoms (runny nose, cough, low grade fever, etc)

Paroxysmal - pt is still contagious, has a paroxsymal “whooping” cough… infants can have apneic spells and cyanosis

Convalescent - pt is not contagious but has a persistent residual cough

200

Mechanism of adenylate cylase toxin?

targets phagocytic cells in lungs, activated by calmodulin to produce higher levels of cAMP which impairs phagocytic functions and disrupts epithelial barrier integrity leading to capillary leakage and fluid accumulation (edema)

300

Tracheal cytotoxin primarily affects which cell type?

Ciliated cells of respiratory epithelium

400

Both cholera toxin and pertussis toxin lead to an increase in what second messenger/intracellular signaling molecule? Bonus: how?

• cAMP

• Cholera toxin: ADP-ribosylation of stimulatory G protein (Gs) → activates adenylate cyclase → increased cAMP

• ADP-ribosylation of inhibitory G protein (Gi) → prevents inhibition of adenylate cyclase → increased cAMP

pharm

100

MOA of ceftriaxone?

Binds to penicillin binding protein (PBP) → prevents peptidoglycan formation → cell wall disruption

200

MOA of azithromycin? Bonus: what class of antibiotics is azithromycin in?

• MOA: Binds to 23S portion of 50S ribosomal subunit in bacteria → inhibition of protein synthesis

• Class: macrolides

300

Would glucocorticoids be beneficial to infants with a pertussis infection?

No

400

Glucocorticoids increase/decrease Nf-kB signaling?

Decrease

vaccines

100

The DTaP vaccine is a (subunit/toxoid/inactivated/live attenuated vaccine)?

Subunit and toxoid (made of both proteins and toxins)

200

What is included in the DTaP vaccine to protect against pertussis?

Pertussis toxin, filamentous hemagglutinin, pertactin, and fimbriae

300

What’s the difference between DTaP and Tdap?

• DTaP = contains more diphtheria and pertussis toxins, given to children under 7 years old in a 5-dose schedule

• Tdap = booster vaccine given every 10 years; contains less diphtheria and pertussis toxins

400

Is the Tdap vaccine safe to administer to pregnant women?

Yes, and can be beneficial to protect the mother and baby