First Aid USMLE STEP 1 flashcards(A PLUS graded)

First Aid USMLE STEP 1 flashcards follicle Ans- site in lymph node of B cell localization and proliferation paracortex Ans- site in lymph node that houses T cells third Ans- What pharyngeal pouch is the thymus derived from? MHC I Ans- present endogenously synthesized antigens? MHC II Ans- present exogenously synthesized antigens? MHC I Ans- antigen peptides are loaded onto MHC I in RER after delivery via TAP? MHC II Ans- antigen loaded following release of invariant chain in an acidifed endosome? CD8 T cell Ans- Tcell that directly kills virus infected cells? cortex Ans- What part of the thymus does positive selection of T cells occur in? medulla Ans- What part of the thymus does negative selection of T cells occur in? autoimmune polyendocrine syndrome-1 Ans- Deficiency of autoimmune regulator AIRE in negative selection leads to what syndrome? Th1 cell Ans- Helper T cell type that secrets IFN-y? Th2 cell Ans- Helper T cell type that secretes IL4, IL5, IL10, and IL13? IL 10 and TGF B Ans- The anti inflammatory cytokines? IgG Ans- Immunoglobulin that can cross the placenta? C3b Ans- Complement protein for opsonization? C3a, C4a, C5a Ans- Complement proteins for anaphylaxis? C5a Ans- complement protein for neutrophil chemotaxis? C3b Ans- complement protein that helps clear immune complexes? C1 esterase inhibitor deficiency Ans- Complement disorder that causes hereditary angioedema due to unregulated activation of kallidrein which leads to inc bradykinin and Ace inhibitors are contraindicated? C3 deficiency Ans- complement disorder that inc risk of severe, recurrent pyogenic sinus and respiratory tract infections and inc susceptibility to type III hypersensitivity reactions? C5-C9 deficiency Ans- complement disorder that inc susceptibility to recurrent Neisseria bacteremia? DAF (GPI-anchored enzyme) deficiency Ans- Causes complement-mediated lysis of RBCs and paroxysmal nocturnal hemoglobinuria? IL-12 Ans- Cytokine that induces differentiation of T cells into TH1 cells and activates NK cells? Chronic granulomatous disease Ans- Disease with NADPH oxidase deficiency and patients are at higher risk for infection by catalase positive species? BCG, intranasal influenza, MMR, sabin polio, varicella, yellow fever Ans- The live attenuated vaccines? Rabes, influenza (injection), Polio (salk), hep A (RIP Always) Ans- The inactivated or killed vaccines? histamine and tryptase Ans- In anaphylaxis, what do mast cells release? Type I Ans- The hypersensitivity reaction that is anaphylactic and atopic? Type II Ans- The hypersensitivity reaction that is cytotoxic (antibody mediated)? Type III Ans- The hypersensitivity reaction that is immune complex-antigen antibody mediated? Type IV Ans- The hypersensitivity reaction that is delayed (T cell mediated? Myasthenia gravis Ans- Anti-ACh receptor autoantibody is assoc with which disorder? Goodpasture syndrome Ans- Anti-basement membrane autoantibody is assoc with which disorder? SLE, antiphospholipid syndrome Ans- Anticardiolipin and lupus anticoagulant are assoc with which disorders? Limited scleroderma (CREST syndrome) Ans- Anticentromere autoantibody is assoc with which disorder? Pemphigus vulgaris Ans- Anti-desmoglein (anti desmosome) is assoc with which disorder? SLE Ans- Anti-dsDNA and anti Smith autoantibodies are assoc with which disorder? Type I diabetes mellitus Ans- Anti-glutamic acid decarboxylase (GAD 65) autoantibody is assoc with which disorder? Bullous pemphigoid Ans- Antihemidesmosome autoantibody is assoc with which disorder? Drug induced lupus Ans- Anti histone autoantibody is assoc with which disorder? polymyositis, dermatomyositis Ans- Anti-jo-1, anti sRP and anti Mi 2 autoantibodies are assoc with which disorders/ Hashimoto thyroiditis Ans- Antimicrosomal, antithyroglubulin autoantibodies are assoc with which disorder? primary biliary cirrhosis Ans- Antimitochondrial autoantibody is assoc with which disorder? SLE (non specific) Ans- Antinuclear (ANA) autoantibody is assoc with which disorder? pernicious anemia Ans- Antiparietal cell autoantibody is assoc with which disorder? primary membranous nephropathy Ans- Antiphospholipase A2 receptor autoantibody is assoc with which disorder? scleroderma (diffuse) Ans- Anti-Scl-70 (anti DNA topoisomerase I) autoantibody is assoc with which disorder? autoimmune hepatitis type I Ans- Anti smooth muscle autoantibody is assoc with which disorder? Sjogren syndrome Ans- Anti SSA, anti SSB (anti Ro, anti La) autoantibodies are assoc with which disorder? Graves disease Ans- Anti TSH receptor autoantibody is assoc with which disorder? mixed connective tissue disease Ans- Anti U1 RNP (ribonucleoprotein) autoantibody is assoc with which disorder? Lambert Eaton syndrome Ans- Voltage gated clacium channel antibodies are assoc with which disorder? Celiac disease Ans- IgA anti endomysial, Ig A anti tissue transglutaminase autoantibodies are assoc with which disorder? Microscopic polyangiitis, eosinophilic granulomatoisis with polyangiitis (Churg Strauss syndrome) Ans- MPO-ANCA/p-ANCA autoantibodies are assoc with which disorders? Granulomatosis with polyangiitis (Wegeners) Ans- PR3-ANCA/c-ANCA autoantibodies are assoc with which disorder? Rhematoid arthritis Ans- IgM antibody that targets IgG Fc region autoantibody is assoc with which disorder? Rheumatoid arthritis Ans- Anti-CCP (more specific) autoantibody is assoc with which disorder? x linked (Bruton) agammaglobulinemia Ans- Defect in BTK, a tyrosine kinase gene, which leads to no b cell maturation and recurrent bacterial and enteroviral infections after 6 months?? (dec Ig of all classes) Selective IgA deficiency Ans- Most common primary immunodeficiency with inc risk for mucosal infeciton, especially viral, although most patients are asymptomatic? Common variable immunodeficiency Ans- Caused by a defect in B-cell differentiation with an inc risk of autoimmune disease, bronchiectasis, lymphoma, and sinupulmonary infections?? DiGeorge syndrome Ans- Caused by failure to develop 3rd and 4th pharyngeal pouches leading to absent thymus and parathyroids? Presentation includes tetany (hypocalcemia), recurrent viral/fungal infections, and conctruncal abnormalities? IL-12 receptor deficiency Ans- Caused by a dec Th1 response and is autosomeal recessive? Presentation includes disseminated mycobacterial and fungal infections? Job syndrome Ans- Caused by a deficiency of Th17 cells due to STAT3 mutation which leads to imparied recuritment of neutrophils to sites of infection? Presentation includes coarse facies, cold staphylococcal abscesses, retained primary teeth, inc IgE, and dermatologic problems (eczema)? Chronic mucocutaneous candidiasis Ans- Caused by T cell dysfunction and presentation includes Candida albicans infections of skina dn mucous membranes? Severe combined immunodeficiency (SCIDs) Ans- Caused by several types including defective Il 2R gamma chain and adenosine deaminase deficiency and presentation includes failure to thrive, chronic diarrhea, thrush, rureent viral, bacterial, fungal, and protozoal infections for defective cell mediated and humoral immunity? Ataxia telangiectasia Ans- Caused by defects in ATM gene leading to failure to repair DNA double strand breaks and cell cycle arrest and presentation includes cerebellar defects, spider angiomas, and IgA defciency (pulmonary infections)? Hyper IgM syndrome Ans- Commonly due to defective CD40L on Th cells leading to a class switching defect causing severe pyogenic infections early in life as well as opportunistic infection with Pneumocystis, cryptosporidium and CMV? Wiskott Aldrich syndrome Ans- Caused by mutation in WAS gene and T cells are unable to reorganize actn cytoskeleton and the presentation includes thrombocytopeniza, Eczema, and recurrent infections? Leukocyte adhesion deficiency (type 1) Ans- caused by a defect in integrin protein on phagocytes which leads to imparied migration and chemotaxis and presentation includes recureent bacterial sin and mucosal infections, absent pus formation, impaired wound healing and delayed separation of the umbilical cord ( 30 days)? Chediak Higashi syndrome Ans- Caused by protein trafficking defect characterized by impaired phagolysosome formation and presentation includes recurrent pyogenic infections by staph and strep, partial albanism, perpheral neuropathy, nystagmus, giant granules in leukocytes and pancytopenia? Chronic granulomatous disease Ans- Caused by a defect of NADPH oxidase and the nitroblue tetrazolium dye reuction test is obsolete? catalase positive orangisms Ans- chronic granulomatous disease has susceptibility to which type of organisms? hyperacute Ans- type of rejection that had pre existing recipient antibodies that react to donor antigen and is a type II hypersensitivity reaciton? acute Ans- type of rejection that is cellular (cd8 tcells are activated against donor MHCs and is type 4 hypersensitivity) and humoral from abs that develop after transplant? chronic Ans- type of transplant rejection that is type II and IV hypersensitivity with both cellular and humor components and cd4 t cells respond to recipent APCs presnting donor peptides including allogeneic MHC? graft vs host disease Ans- Type of transplant rejection in which grafted immunocompetent t cells preliferate in the immunocompromised host and reject host cells with foregin protiens and is a type 4 hypersensitivity and presents with a maculopapular rash? intrinsic Ans- type of apoptoic path that occurs when a regulating factor is withdrawn from a proliferating cell population and is regulated by Bcl-2 family of proteins such as BAX and BAK (proapoptotic) and Bcl2 (antiapoptotic)? extrinsic Ans- type of apoptotic path that is caused by cytotoxic t cell releasing perforin and granzyme B or a Fas-FasL interaction? autoimmune lymphoproliferative syndrome Ans- Caused by defective Fas-FasL interactions? chromatolysis Ans- Reaction of neuronal cell body to axonal injury and is characterized by inc protein synthesis, round cellular swelling, displacement of the nucleus to the periphery, and dispersion of Nissl substance throughout cytoplasm? Wallerian degeneration Ans- Dengeneration of axon distal to site of injury? Dystrophic calcification Ans- Ca deposition in abnormal tissues secondary to injury or necrosis and is not directly associated with serum Ca levels? Metastatic calcification Ans- Widespread deposition of Ca in normal tissue secondary to hypercalcemia and patients are usually not normocalcemic? Leukocyte adhesion deficiency type 2 Ans- Caused by defective margination and rolling and has dec Sialyl-Lewis? myofibroblasts Ans- Wound contraction is mediated by what? VEGF and FGF Ans- Tissue mediator that stimulates angiogenesis? transthyretin Ans- Heritable amyloidosis is due to a mutation in what gene? Lipofuscin Ans- A yellow brown wear and tear pigment associated with normal aging formed by oxidation and polymerization of autophagocytosed organellar membranes? Chlamydia, Borrelia, Rickettsia, Trypanosomes, Plasmodium (Certain Bugs Really Try my Patience) Ans- Bugs that you use a Giemsa stain for? Whipple disease (Tropheryma whipplei) Ans- Periodic acid Schiff stain is used to diagnose what? Silver stain Ans- Fungi (Coccidiodies, Pneumocystis jirovecii), Legionella, and H pylori use what stain? FTA-ABS Ans- What stain is confirming for syphilis? M tuberculosis Ans- Lowenstein Jensen agar is used to isolate which bacteria? M pneumoniae Ans- Eaton agar is used to isolate which bacteria? fungi Ans- Sabouraudd agar is used to isolate what bug? Rickettsia, chlamydia, coxiella Ans- Which bugs are obligate intracellulars? S. Pneumo, H influenzae type b, Neisseria (SHiN) Ans- Transformation is a feature of what bacteria? Group A strep erythrogenic toxin, Botulinum toxin, Cholera toxin, Diphtheria toxin, Shiga toxin (ABCD'S) Ans- Specialized transduction in which 5 bacterial toxins are encoded in a lysogenic phage? C diphtheriae and Pseudomonas Ans- The bacteria whose toxins inactivate elongation factor2 (EF 2)? Shigella and EHEC Ans- The bacteria whose toxins inactivate 60S ribosome by removing adenine from rRNA? Heat labile Ans- ETEC toxin that overactivates cAMP? heat stable Ans- ETEC toxin that overactivates cGMP? B. anthracis Ans- Bacteria whose toxin (edema toxin) mimics the adenylate cyclase enzyme (inc cAMP)? V cholerae Ans- Bacteria whose toxin overactivates adenylate cyclase (Inc cAMP) by permanently activating Gs? B pertussis Ans- Bacteria whose toxin overactivates adenylate cyclase by diabling Gi and impairing phagocytosis to permit survival of microbe? C perfringens Ans- Bacteria whose toxin is a phospholipase (lecithinase) that degrades tissue and cell membranes? B anthracis Ans- The only bacterium with a polypeptide capsule (contains D glutamate)? sulfonamides Ans- What do you treat nocardia infections with? Penicillin Ans- What do you treat actinomyces infections with? azithromycin Ans- What is the antibiotic for prophylaxis for M avium intracellulare when the CD4 count is less than 50? Cord factor Ans- Factor of Mycobacteria that inhibits macrophage maturation and induces release of TNF alpha? sulfatides Ans- Factor o mycobacteria that inhibits phagolysosomal fusion? Lepromatous Ans- Type of leprosy that has a negative skin test and is characterized by low cell mediated immunity with a humoral Th2 response? Tuberculoid Ans- type of leprosy that is characterized by high cell mediated immunity with a largely TH1 type immune response and a positive skin test? Kelebsiella, E coli, Enterobacter and Serratia (MacConKEE'S) Ans- Which bacteria are lactose fermenting? Ecthyma gangrenosum Ans- A rapidly progressive necrotic cutaneous lesion caused by Pseudomonas bacterema typically seen in immunocompromised patients with neutropenia? fimbriae Ans- E coli virulence factor that causes cystitis and pyelonephritis? K capsule Ans- E coli virulence factor that causes pneumonia and neonatal meningitis? LPS endotoxin Ans- E coli virulence factor that causes septic shock? H pylori Ans- Bacteria that is catalase, oxidase, and urease positive? Weil disease Ans- A icterohemorrhagic leptospirosis that is a severe form with jaundice and azotemia from liver and kidney dysfunciton, fever, hemorrhage, and anemia? doxycycline Ans- Treatment for Lyme disease? Jarisch-Herxheimer reaction Ans- Flu like syndrome after antibiotics are started (esp in syphilis) due to killed bacteria (usually spirochetes) releasing toxins? Gardnerella vaginalis Ans- Involved in bacterial vaginosis that presents as a gray vaginal discharge with a fishy smell and is nonpainful and is associated with sexual activity and is characterized by Clue cells? Typhus (typhi and prowazekii) Ans- Which type of Rickettsial disease rash spares the palms and soles? Chlamydia trachomatis Ans- What bacteria causes reactive arthritis, follicular conjunctivitis, nongonococcal urethritis, and PID? peptidoglycan Ans- What does the chlamydial cell wall lack that most bacterial walls have and renders B lactam antibiotics less effective? Blastomycosis Ans- Fungi that are characterized by broad base budding? Candida Ans- Fungus that forms germ tubes at 37 C? TMP-SMX Ans- Treatment and prophylaxis for Pneumocystis jirovecii? potassium iodide Ans- Tx for sporothrix involves either itraconazole or this? Naegleria fowleri Ans- casues rapidly fatal meningoencephalitis and is transmitted by freshwater that enters the cribiformplate and you will find amoebas in the spinal fluid? P vivax/ovale Ans- type of malaria that has a 48 hour cycle? P falciparum Ans- type of malaria that has sever, irregular fever patterns? P malariae Ans- type of malaria that has a 72 hour cycle? Babeiosis Ans- Disease characterized by fever and hemolytic anemia predominantly in northeastern US and asplenia inc the risk of severe disease? It also is transmitted by a tick Trichomonas vaginalis Ans- Vaginitis characterize by foul smelling greenish discharge, itching and burning, and strawberry cervix and is transmitted sexually?