Sheet1What is it?RelevancePneumonicWhat it stands forNotesCatalase positive organismsCGDPLACESSPseudomonas, listeria, aspergillus, candida, e. coli, serratia, staph aureus VIPomaassociationsWDHAwatery diarrhea, hypoK, achlorhydria Wilm's tumorassociationsWAGRWilm's, anniridia, genitourinary malformation, mental retardaion Facultatively intracellular bacteriahumoral immunity ineffective Some Nasty Bugs May Live FacultativeLYSalmonella, Neisseria, Brucella, Mycobacteria, Listeria, Francisella, Legionella, YersiniaIgA protease producersCan adhere to respiratory mucusSHiNStrep pneumo, H-flu, Neisseria PNH TriadTriadHemolytic anemia, venous thrombosis, pancytopeniaCrew-cut on Xraydue to bone marrow expansionThalasemia (beta major), sickle cell anemiaAbsent thymic shadowlack of T cell responseDiGeorge's, SCID (combined T&B cell def.)Aplastic Crisis w/B19 parvoInfectionSickle cell anemia, spherocytosis, beta thalassemiaAcute intermittent porphyriaSymptoms5 P'sPainful ab, portwine colored urine on standing, polyneuropathy, psychological issues, precipitated by Rx - PhenobarbitalTTPSymptomsPentadFever, Thrombocytopenia, Microangiopathic Hemolytic anemia (shistocytes), renal Sx, CNS abnormalities (headache)NaphthaleneCorelationAnaline Dyes & moth ballsTransitional cell carcinoma of uroepithelium & howel-jowel bodies in blood (nuclear remanent)Cystinuria AA'sAA's affected in PCT COLAcysteine, ornithine, lysine, arginineMaple syrup urine dzbranched AA due to dec in alpha-ketoacid dehydrogenase (B1)I love vermont maple syrupIle, Leu, ValH1 blockers 2nd gen.Lor, Fex, Des, CetLoratadine, Fexofenadine, Desloratadine, CetirizineH1 blockers 1nd gen.Sedatives, antimuscarinic, anti-alpha adrenergic1st gen of K Hydes their Diamonds (2) & Promote ConspiracyHydroxyzine, Diphenhydramine, Dimenhydrinate, Promethazine, Chlorpheniramineshort-acting BZDless than 10 hoursTAO- MansionTriazolam, Alprazolam, Oxazepam, Midazolammedium-acting BZD10-20 hrsLorenzapam, Estazolam, Temezapamlong-acting BZDdaysChlordiazeproxide, Clorazepate, Diazepam, Flurazepam Negative Stranded RNA virusesMust bring a polymerase - naked can't infectAlways bring polymerase or fail replicationArena, Bunya, Paramyovirus, Ortho, Filo, RhabdoOther ones that can't replicate as naked strands: HBV, PoxGingival hyperplasia from RxPVC on gumsPhenytoin, Verapamil, Cyclosporine (the immuno drug)Azathioprine & 6-MP Increased concentrationXanthine Oxididase inhibits their degradation FebuxostatInhibits xanthine oxidaseIn February, I was snowed in and couldn't find allopurinolUse Febuxostat instead of allopurinol Wilson's DzChromosomeMr. Wilson was unlucky on Denis the menaceChromsome 13 w/ATP7B mutantCephalosporins for Pseudomonas3rd and 4th generationDime & PimeCeftazidime & Cefepime "-gliptins"DPP-4 inhibitorsLike Poppy Liptin!Prevent breakdown of GLP-1, inc insulin and dec glucagon; SE: urinary/respiratory infections"-tides" GLP-1 analogsIncrease insulin, dec glucagon; SE: nausea, diarrhea, pancreatitis PTUIs liver toxicP-U your liver stinksProtein phosphataseActivated by insulindephos glycogen synthase = glyco syn; dephos F1,6BPase = stops gluconeogenesisBromocriptine & PergolideThe PD Rx that vasoconstrictThese will raise your BPBromo & Pergolide, the ergot'sMemantine for ADMy mema got AD and now I have to block her bank acct at NMDA bankMemantine blocks NMDA R; prevents excitotoxicity; SE: dizzy, hallucinations, confusionDonepezil, Galantamine, RivastigmineDone Galavanting thru the Riva once I got ADAchetylcholinesterase inhibitors for AD; SE: nausea, dizzy, insomnia Zafirlukast, MontelukastThe LKTs auditioned for the "kast" but failedRx that block LTC4, D4 & E4 for asthma control; esp good for aspirin-induced asthma ProbenacidFor goutPisses out uric acid & prevents PCN from clearingblocks uric acid reabs in the PCTLipoteichoic acidGPs bugs onlyLipoteichoic acid lights on fireInduces TNF and IL-1LPS/outer membrane/endotoxinGNs onlyLipid A induces TNF & IL-1; O polysaccharide is the antigen determinator glycocaylxMediates adherence to foreign objects (cath)Adhere's to things from another "galaxy"Made of polysaccharideSpirochetesBLTBorrelia (Giemsa), Leptospira, Treponema Gram stain limitsCan't see theseThese Rascals May Microscopically Lack ColorTreponema, Rick, Mycoplasma, Mycobacteria, Legionella, Chlamydia Obligate AerobesO2-dep system to generate ATPNagging Pest Must BreathNocardia, Pseudomonas, Mycobacteria, Bacillus Obligate AnaerobesFoul smelling, produce gas in tissue (CO2 & H2)ABCActinomyces, Bacteroides, Clostridium - all lack catalase and/or superoxide dismutaseObligate Intracellular BugsCan't make their own ATPReally ColdRickettsia & Chlamydia Encapsulated BugsQuelling Rxtn, opsonized & cleared by spleenSHiN SKiSStrep pneumo, H-flu, Neisseria men, Salmonella, Klebsiella, Group B Strep PneumovaxPolysach vac w/no conjugated proteinPrevnar is the one that is conjugated; other inc: H-flu & meningitis Urease bugsMake ammonium from ureaChuck norris hates PUNKSSCrypto, H pylori, proteus, ureaplasma, nocardia, klebsiella, staph epi, staph saprophyticusStrep pyogenes exotoxinsOA was full of pyogenesstreptolysin O (degrades cell mem, lyses RBCs), Exotoxin A (superAg = shock via IFN-gamma & IL2)Genes for bacterial toxins in lysogenic phageNeed phage to express toxinsABCDEShigA-like toxin, Botulinum, Cholera, Diptheria, Erythrogenic toxin of strep pyogenes Listeria is beta hemolyticB is for BabiesBeta hemolysis listeriaType I & II muscle fibersFirst you eat tasty red meat and then be healthy w/white meattype I is slow, aerobic, lots of mito, lots of myoglobulin, less glycogen fibers; Iib: fast w/glycogenlysis followed by glycolysis; Iia: fast-twitch fibersNonsense mutantIt's nonsense that we have a substitute todayNonesense mutants are caused by substitions while frameshifts are from deletions not 3Nematodes acquired thru ingestion EATEnterobius, Ascaris lumbricoides, Trichinella (pig)Nematodes acquired thru skinThese get in your feet when walking in SANdStrongyloides, Ancylostoma, NecatorDracunculus medinensis - how to acquireDracula drinks your bloodAcquire from drinking water; extract via taking out slowly from skin ulcerTx for Loa Loa and Wuchereria bancroftiWitch crafted a spell on Ethyl called Loa LoaThe tX for both nematodes is EiethylcarbamazineTx for EchinococcusEcho can hear the dog & echos tx of roundworms & echos in liverTx is "-bendazoles" and the vector is ingestion of eggs from sheep dog feces Tx for neurocysticercosisBending over b/c your brain hurtsTaenia solium causes cysticercosis & neuro --> use "-bendazoles" for the latter (praz for former)Enterobius vermicularisTx: Bendazole or pyrantelSx: anal itching

Ascaris lumbricoidesTx: Bendazole or pyrantelMigration thru the tissues produces allergies mediated by Eosinophils & IgE --> SOB, wheezing, utricaria

Strongyloides stercoralisTx: Ivermectin or albendazlelarva in soil penetrate the skinSx: vomit, diarrhea, anemia

Ancylostoma Duodenale/Necator americanus (hookworms)Tx: bendazoles or pyrantel pamoatelarva penetrate skin Sx: anemia due to sucking bl from intestinal wallsOnchocerca volvulusHerpes pics:vector: female balckfly biteTx: Ivermectin (iver = river)Sx: hyperpigmented skin & river blindness Loa LoaLeishmania pic: + the one in FA w/it inside the macvector: deer fly, horse fly, mango flySx: swlling in skin, worm in conjunctivaTx: DiethylcarbamazineWuchereria BancroftiHas a long incubation period also like RABIES - weeks to months b/c Sx onsetvector: female mosquitoeSx: lymphatics blocked --> takes 9mo-1y --> elephantitisAspergillus v. Mucor pics: Tx: DiethylcarbamazineToxocara canisvector: foodSx: viceral larva migransTx: albendazole or mebendazole Tx for Strongyloies & OnchocercaThe Strong Oncho needed some IvermectinIvermectin is used for Strongyloides & OnchocercaDiphyllobothrium, Clonorchis, ParagoniumusThe worms that are acquired thru freshwaterI'll Di Cloning the ParachuteDi is thru raw freshwater fish (larvae), Clone is from undercooked fish, Para is from undercooked crab meatSchistosoma MansoniMansoni is like a mansion created in your liver & spleen w/granulomas, fibrosis & pipestream perioportal fibrosisSchistosoma haematobium Mansoni also is a man and has a Dee --> see picture of eggChlamydia pathwayElementary body is Enfectious & Enters cell via EndocytosisVs. Reticulate body that replicates by fission Chlamydia A, B, CAfrica, Blindness, ChronicChronic infection types, can cause blindness from follicular conjunctivitis in AfricaChlamydia D-KEverything elseUrethritis, neonate pneumonia & conjunctivitis Other tineaAre so abundant that they don't need to be dimorphicJust appear in mold formMucor & Aspergillus also only appear as mold form3 tests for cryptococcusLatex agglutination detects capsular AgIndia inkMucicarmine stain (also silver stain)Mucor & rhizorForm a "core" thru bl vessels and into brainprolif in bl vessel, to cribiform plate, form frontal lobe abscess; biopsy for dx in diabeticsPCPPCP was how AIDS was first discoveredSo it's the FIRST thing to prophylax for when Tcell toxic shock Cowdry intranuclear inclusions pic: Cryptosporidium w/basophilic clusters: see pic belowKrabbe's Dz w/globoid cells in brain (multinucleated giant cells of fused microglia) - pic here:SE of MacrolidesMACROmotility issues, arry (prolong QT), acute cholestatic hepatitis, rash, eOsinOphilia transudate sg1.020DPC4tumor suppressor geneDPC4deleted in pancreatic cancerDCCtumor suppressor geneDCCdeleted in colon CAPyrophosphate analogsFoscarnet & AlendronateF is used in CMV Tx & A is used in osteoporosis Tx & Paget'sb/c inhibits osteoclast activity Fabry'sAngiokeratoma (granuloma w/ceramide), cardiac/renal, painful neuropathyGaucher'sMacrophages w/tissue paper, hepatosplenomegaly, pancytopenia, severe bone painHurler'sGargoylism, corneal clouding, hepatosplenomegaly, development delayHunter'sSee above w/o corneal cloudingNiemann-PickHepatosplenomegaly, cherr-red spot macula, foam cells, progressive neurodegenerationTay-Sach'sCherry spot + progressive neurodegeneration"startles w/loud noise, can no longer sit or rolls over, regression of motor skills by 1yo"KrabbeOptic atrophy + progressive neurodegenerationMetachromatic LeukodystrophyMuscle wasting, dementia, ataxia Nerve injuryshrinkage of cell body, pyknosis of nuc, loss of nissl, nucleolus disappears, eosinophilic cytoAxonal reactionenlarged cell body, eccentric nuc, enlarged nucleolus, dispersed nissl bacterial meningitis protein leveltypically >100; but w/aseptic M = can X BBB to fix atropine OD there too, unlike other RxNeostimgmineReverses Neuromuscluar junction blockadeAlso for postop & neurogenic ileus, urinary retention, Myasthenia gravisPyridostigmineGet's 'rid' of myasthenia gravislong-acting, doesn't penetrate CNSBenztropinePark my Benzused for PD to dec ACH activityIpratropium & tiotropiumI pray I can breath again soonCOPD & asthma Ritodrine & terbutalineI dont wanna get Rit of this Turdact on beta2 and cause tocolysis, or dec in premature uterine contractions Sulfa drugsPopular FACTSSSProbenacid, Furosemide, Acetazolamide, Celecoxib, Thiazides, sulfonamide Abs, sulfasalazine, sulfonylureasPartial beta agonistscontraindicated in anginaPAPAPartial beta Agonists = Pindolol & Acebutololbeta agonistsused for asthma - beta2-terol'albuterol, metaproterenol (short-actors), salmeterol (long-acting)beta antagonists - nonselectivePlease Try Not being PickyPropanolol, Timolol, Nadolol, Pindololbeta antagonists - selective for beta1BEAMBextaxolol, Esmolol (short-acting), Atenolol, MetoprololNonselective vasodilatory alpha and beta antagonistsCLCarvedilol, LabetalolDigitalis toxicity txhyperK is worse PxKLAMNormalize K, Lidocaine, anti-dig Fab fragments, Mg++Reason why chloramphenicol = gray baby syndromelack UDP-glucuronyl transferase needed to eliminate Rx thru glucuronidate Megaloblastic anemia RxHave a blast with PMSPhenytoin, Methotrexate, Sulfa drugs (probably trimethoprim too for tx toxo)Toxoplasmosis TxThese drugs have Toxic namesTriMETHoprime, and SULFadazineGynecomastia drugsSome Drugs Create Awkward KnockersSpironolactone, Digitalis, Cimetidine, chronic Alcohol use, KetoconazoleHypoT creating drugsLASLi, Amiodarone, sulfonamidesClass 1A, B C anti-arry RxDouble Quarter pouder, Lettuce Tomatoe Mayo, More Fries, PleaseDisopyrimide, Quinidine, Procainadmie, Lidocaine, Tocainide, Mexiletine, Flecainide, Propafenone, MoricizineSeizure Rx SeI BITE MouthISN, Bupropion, Imipenem/cilastin, Tramadol, Enflurane, MetoclopramideAntimuscarinics RxCause Hot as hare, dry as bone, red as beet, mad as hatter, urinary retention, hyperthermia, etcAtropine, TCAs, H1-blockers, neurolepticsIL-4 & IL-10Inhibitors of Th1At 4 and 10 yo you were inhibited form getting a dogfrom Th2 that inhibits Th1while IFN-gamma from Th1 inhibits Th2Fc regionthe constant region of IgAll C's forConstant, Carboxy terminal, complement bind at CH2 (only G&M), Carbohydrate side chaindetermines isotype vs Fab region that determines idiotype SCID triadrecurrent infections, failure to thrive, diarrheaIgEactivates masts, basophils, eosinophilsB/c we don't need a lot of helminthsmeaning that its the lowest concentration in the serum Basophilic StipplingrRNA left overbaste the TAiLThalassemia, Anemia of chronic dz, Lead poisoningPb poisoning in the background of hypochromactic microcytic anemia w/ab pain, food drop & constipationTarget cellsMembrane issueHALTHbC, Asplenia, Liver dz, ThalassemiaReactions that take place in BOTH the cytoplasm & mitoHUGs take 2Heme synthesis (first and last steps), Urea cycle (first), Gluconeogenesis (first step also)Malate-aspartate shuttle vs. glycerol-3-phosphate shuttleATP production w/NADH/FADMalate Makes more for heart and liver NOT MuscleMalate makes 32 ATP in heart and liver & Glycerol shuttle makes 30ATP for musclePyruvate Dehydrogenase complex deficiencySx: neuro defects in infancyE1 alpha was born without energyX-linked defect for E1alpha subunit of PDC; Tx: inc ketogenic nutrients like high fat content or inc Lysine & LeucineRotenoneInhibits complex1 of ETCIt's Right to be No.1caues dec proteon gradient & therefore a block of protein synthesis Barbituate OD also inhibits complex 1Gluconeogenesis stepsPathway Produces Fresh GlucosePyruvate carboxylase (mito), PEP carboxykinase (cyto), F16BPase (cyto), Glucose-6-phosphatase (ER - def in Von Gierke's)NADPH oxidase ismembrane bound!Heinz bodiesfrom oxidative damage in G6PD-defHeinz bodies are oxidized Hemoglobin thats precipitated in RBCFructose intolerancedef aldolase BYou have apple juice in ur skin, all this sugar but can't make it!Sx: phosphate depletion results in dec glycogenolysis & dec gluconeogenes = hypoG, jaundice (apple juice), cirrhosis, vomitingAA for grwothArg His is growing!Arginine & HistineAA that are negativeAspartic acid & Glutamic acidAspartate & GlutamateAA that are glucogenicGlucose Met His ValMet, His, ValAA in histonesLA makes HistoryLysine & ArginineThymineThymine has a methylGuanineGuam holds the keyGuanine has a ketoneAA for purine synthesisGAGGlutamine + Aspartate + Glycine (the 2 acidic ones plus a neutral one)Also requires THFPhosphodiester bonds btwn nucleotides (3'-5')Hydrogen bonds btwn paried bases --> A & GRifampin MechanismTB med (1 of 4)R's: RNA polymerase-I, Revs up P450, Red/orange body fluids, Rapid Resistance if used solotypes of RNArampant, massive, tinyrRNA is most abundant, mRNA is longest type, tRNA is the smallestOrder of protein synthesisopposite alphabeticalProtein is synthesized from the N-terminus to C-terminustRNA75-90bpCan Carry Amino acidsCCA region on 3' end holds amino acid via ATP and aminoacyl-tRNA synthetase ATPase'sUse ATPCFTR & Axonemal dynein (mutated in CF and Kartagener's respectively)FISHFluorescence in situ hybridizationFish swim around to look for parts of crhomosomessenses microdeletion --> don't light up if deleted; more detailed than karyotype analysisSpeed of cells in heart: fastest to slowestPark At Ventura AvePurkinjes, Atria, Ventricles, AV nodeHuntington's chromosomeHunting 4 foodChromosome 4ADPKD chromosomeSwitch P and L in Poly and rotate P=Chromosome 16Muscular DystrophyCaptain Dystrophin threw his anchor overboardDystrophin anchors muscle fibers in skeletal & cardiac musc.Down's heart defectDown's was the first genetic dz you knew aboutASD of ostium primum type; also if due to robertsonian translocation, it's unbalanced!WilliamsWilliam keeps his smile lastin'Deletion region includes elastin (MCC death: heart issue), friendly, verbal, elfin, hyperCa, intellectual disabilityB1 def in alcoholicsWet beribert: HIGH OUTPUT heart failure3 causes of depleted niacin and so diarrhea, dementia, dermHartnup dz (dec trypt abs), carcinoid tumor (inc tryp use), INH (dec B6 needed for making Niacin)All the uses of vitB6transaminase, decarboxylase, glycogen phosphorylase, making cystathionine, heme, niacin, histamine, GABA, serotonin, NE, Epiwhenever you see sideroblastic anemiait means you can't make the porphoryn of heme of HemoglobinVitA used as TxM-wordsAML (M3) & MeaslesVitE defE for ErythrocyteDef causes hemolytic anemia due to increased fragility of RBC membranedef also causes musc weakness, post column and spinocerebellar tract damageRCC triadhematuria, flank pain & palpable mass in abdomenDysgerminomahCG, LDHmalig, seminoma equiv, sheets of uniform cells, Turner'sChoriocarcinomahCGmalig trophoblastic tissue, no chorionic vili, theca-lutein cysts, hem spread to lungsYolk sac (endodermal sinus) tumorAFPsacrococcygeal region, aggressive, Schiller-Duval bodies (~glomeruli)Teratomaaka mature desmoid cystcalcifictations in the pelvic region seen on XRAYbenign (mature, dermoid cyst, 2-3 germ), immautre - aggressive/malignant/neuroectoderm), Stuma ovarii = thryoid = hyperthyroidismSerous cystadenomabilateral, fallopian-tube-like epithelium, benignserous cystadenocarcinomabilateral, malignant, psamomma bodiesa/w BRCA1/2, HNPCC = family Hx is most important risk factorMucinous cystadenomamultilocular cyst lined by mucus-secreting epi; intestine-like tissue, benignMucinous cystadenocarcinomamalig, pseusomyxoma peritonei = mucinous accum in peritoneum from appendix or ovarian mucinous tumor, "jelly belly"Brennercoffee bean nuclei, encapsulated yellow-tan, looks like bladder, benign & unilateralFibromaspindle-shaped fibroblasts, Meig's syndrome: ovarian fibroma, pleural effusion (hydrothorax), asceitesGranulosa cell tumorsecretes estrogen (percocious puberty), hyperplasia in adults, call-exner bodies (follicles w/eosinophilic secretions)SeminomaPLAPDysgerminoma equivalent, homogenous, MC, 15-35, fired egg, radiosensitive & good PxYolk sac (endodermal sinus) tumorAFPYellow, mucinous, primitive glomeruli (schiller-duval)ChoriocarcinomahCG*see above; gynecomastia b/c hCG is an LH analog Teratoma (male)hCG/AFPmature teratoma in males is often malignant, children is benign Embryonal carcinomahCG w/norm AFP, or inc AFP when mixedpainful, malig, glandular/papillary morph, usu mixed w/other tumor types, hem/necrotic = fast growing & maligRiboflavin defThe 2C's of B2Cheilosis & Corneal vascularization (older person w/cracking corners of lips)PNH triadHemolytic anemia, pro-thrombotic state (hepatic vein), decreased blood countsdeficiency in CD55 & CD59 is diagnosticBeck's Triad for Cardiac TamponadeHypotension, distended neck veins, muffled heart sounds