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Hi Yield 16.0 - 22.0

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mhewett's version from 2016-07-02 18:55

Section 16.0 Skin Tumors

Question Answer
What type of skin lesion is said to have a stuck on appearance?Seborrheic keratosis
What type of skin lesion is said to have a velvety/greasy feel?Seborrheic keratosis
What type of skin lesion presents as a flesh-colored dome-shaped nodule with a keratin-filled plug? What parts of the body are usually affected?Keratoacanthoma; (1) Face (2) Hands
What is the most common premalignant skin lesion? What is the most common cause?Actinic keratosis; Excess sun exposure
What is the most common malignancy in the US?Basal cell carcinoma
What type of skin cancer presents as a waxy/pearly nodule with telangiectatic vessels?Basal cell carcinoma
What type of skin cancer is associated with a shallow ulcer surrounded by a wide elevated border?Squamous cell carcinoma
What type of skin cancer is associated with damage to Langerhans cells?Squamous cell carcinoma
What type of skin cancer often develops from pre-existing nevi? What is the most important diagnostic factor? What is the most important prognositic factor?Melanoma; Change in color; Depth of invasion
What are the five components of the ABCDE mnemonic for evaluating melanoma?(1) Asymmetry (2) Border (3) Color (4) Diameter (>6mm) (5) Evolving
The overwhelming majority of precancerous and cancerous skin lesions are caused by _____.Sun exposure
In terms of skin cancer, _____ is to the top lip, while _____ is to the bottom lip.Basal cell carcinoma, Squamous cell carcinoma
What dermatologic condition presents as thickened, gray-white plaques in the genital region of males and females? What infection can be found in greater than 90% of these patients?Bowen disease; HPV (typically type 16)
What dermatologic condition presents as multiple, pigmented papules on the external genitalia of males (often mimic condyloma acuminatum)?Bowenoid papulosis
What dermatologic condition presents as single or multiple, shiny, red plaques (sometimes velvety) on the glans penis or prepuce?Erythroplasia of Queyrat
Which of the following rarely transitions to squamous cell carcinoma? Is associated with visceral malignancy? (A) Bowen disease (B) Bowenoid papulosis (C) Erythroplasia of Queyrat(B) Bowenoid papulosis; (A) Bowen disease
memorize

Section 16.1 Other Skin Diseases

Question Answer
What autoimmune disorder is characterized by nikolsky's sign, oral and skin erosions? What is the autoantibody associated with the condition?Pemphigus; Anti-keratinocyte junction
What skin disorder is characterized histologically by acantholysis? What is acantholysis?Pemphigus; Lysis of intercellular adhesion sites
What autoimmune disorder is characterized by bullae and pruritis? What is the autoantibody associated with this condition?Bullous pemphigoid; Anti-epidermal basement membrane
What skin disorder is characterized histologically by sub-epidermal non-acantholytic blisters?Bullous pemphigoid
What skin condition is characterized by crusted skin lesions usually on the hands or face? What are the two most common causes of this disease?Impetigo; (1) Streptococcus pyogenes (2) Staphylococcus aureus
What skin condition is often associated with a herald patch? Rhinophyma?Pityriasis (pityriasis rosea); Rosacea
What skin condition is characterized by lesions with a christmas tree appearance? A spaghetti and meatball appearance of microscopy?Pityriasis (pityriasis rosea); Tinea versicolor
What chronic skin condition is characterized by erythema, telangiectasias, superficial pustules, and facial flushing? Are these superficial pustules associated with comedones?Rosacea; No
What chronic skin condition is often exacerbated by heat, alcohol, spicy foods, and hot drinks?Rosacea
What skin condition often presents as hyper- or hypopigmented scaly patches? What is the most common causative agent?Tinea versicolor; Malassezia furfur
What skin condition is characterized by sharply demarcated, erythematous plaques with thick silvery scales? Is this lesion usually pruritic?Psoriasis; No
Where does seborrheic dermatitis most commonly occur?Scalp (yielding severe dandruff)
What skin condition occurs in oil-rich areas, primarily the face and scalp?Seborrheic dermatitis
What is Stevens-Johnson syndrome?delayed hypersensitivity resulting in keratinocyte death with subsequent separation of epidermis from dermis; when more than 30% of body surface area has detached, it is toxic epidermal necrolysis (TEN)
What skin condition is characterized by pruritic, erythematous, rash with edema?Eczema
What skin condition is often associated with asthma and hay fever (type I hypersensitivity reaction)?Eczema
What is the most common type of vascular tumor?Capillary hemangioma
What neurocutaneous disorder is associated with a port wine stain, seizures, glaucoma, and learning disability?Sturge-weber disease
What type of vascular tumor is associated with the port wine stain seen in Sturge-weber disease?Cavernous hemangioma
What is a xanthoma?cholesterol accumulations within the dermis
What autoimmune disorder is characterized by flat, non-pigmented macules? What is the autoantibody associated with the condition?Vitiligo; Anti-melanocyte
What skin condition is associated with localized hyperplasia of melanocytes, yielding small, oval, tan macules?Lentigo
What skin condition is associated with liver spots? Neonatal cradle cap?Lentigo; Seborrheic dermatitis
memorize

Section 17.0 Toxins

Question Answer
What toxin is known to form reactive oxygen species? What is the antidote?Iron; Deferoxamine
What toxin interferes with heme synthesis and alters membrane structure? What is the antidote?Lead; EDTA or BAL
What toxin inhibits several enzymatic processes, especially those involved in oxidative phosphorylation? What is the antidote?Arsenic; Dimercaprol/penicillamine
What toxin blocks cytochrome C in the electron transport chain? What is the antidote?Cyanide; Amyl nitrate
What toxin binds to hemoglobin, thereby reducing oxygen binding and delivery to tissue? What is the antidote?Carbon monoxide; Oxygen
What toxin is often found in welding, paints, and pigments?Cadmium
What toxin is often due to vitamin B12 intoxication, drilling/milling metals, and laboratories?Cobalt
What toxin is often associated with pink gastric lavage? What is the long-term outcome of this toxicity?Cobalt; Dilated cardiomyopathy
What toxin is often found in paints (especially brightly colored ones)? What blood disorder is often associated with this toxicity?Lead; Microcytic anemia
What toxin is associated with Burton's lines (bluish-black lines across gingivae)?Lead
What toxin often presents with paresthesias, tremors, ataxia, and blindness?Mercury
What toxin is often found in fish and glass thermometers?Mercury
What toxin is often associated with "garlic breath"? Scent of bitter almonds on autopsy?Arsenic; Cyanide
What toxin is known to cause apical pleural thickening on chest x-ray? What disease often arises from this toxicity?Asbestos; Mesothelioma
What toxin is found in red and yellow food dyes, hair dyes, and tobacco smoke?Aromatic amines
What toxin is associated with bladder cancer following chronic exposure?Aromatic amines
What toxin is often found in research laboratories and is commonly associated with severe bone marrow damage?Benzene
What toxin is associated with incinerators, tattooing and dietary supplements?Chromium
What toxin is often associated with PVC-packed foods, refrigerants, and workers in vinyl chloride manufacturing?Vinyl chloride
What toxin is found toadstools and poison mushrooms?Alpha-amanitin
What toxin is associated with cherry red lips, extreme anxiety, followed by stupor and often death?Carbon monoxide
What toxin is found in cherry pits, apricot pits, and raw cassava?Cyanide
What toxin is associated with basophilic stippling of erythrocytes?Lead
memorize

Section 18.0 STAINS

Question Answer
What two bacteria are said to be acid fast (+)? What is another name for the acid fast stain?(1) Mycobacteria (2) Nocardia; Ziehl Neelsen stain
What type of stain is used to detect bacteria with waxy cell walls?Acid fast (Ziehl Neelsen) stain
What fungus is detected by india ink?Cryptococcus
What is a Giemsa stain?general stain for blood smears and gives a differential stain
A periodic acid-schiff stain test for the presence of _____, while a prussian blue stain tests for the presence of _____.Polysaccharides; Iron
What does a congo red stain detect?Amyloid
When viewed under a light microscope, what color does congo red stain amyloid? What color is it when viewed under a polarizing light microscope?Red, Apple-green
What is osmic acid?fixative and stains for electron microscopy
After a gram stain, what color are gram (+) organisms? Gram (-)?Blue-violet; Pink-red
What are the four steps of gram staining?(1) Crystal violet (2) Gram's iodine (3) Alcohol (4) Safranin
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Section 19.0 Normal Flora

Question Answer
What are the 2 major roles of normal flora?1) stimulate immune system to keep health and surveillance ability
2) interfere with colonization by pathogens
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Section 20.0 Cell Walls

Question Answer
What is the only bacteria without a cell wall?Mycoplasma
What is the only bacteria without peptidoglycan in its cells wall?Chlamydia
What does a gram + cell wall consist of?peptidoglycan and teichoic acid
Would you expect to find lipopolysaccharide (LPS) in gram (+) or gram (-) bacteria?Gram (-)
Which bacteria has a waxy cell wall with mycolic acid?mycobacteria
What two bacteria have the ability to form spores?(1) Bacillus (2) Clostridium
What are the three clinically important encapsulated bacteria?(1) Streptococcus pneumoniae (2) Neisseria meningitidis (3) Haemophilus influenzae
memorize

Section 21.0 Bacterial Toxins

Question Answer
What component of lipopolysaccharides makes up the endotoxin found in gram (-) bacteria?Lipid A
Are O antigens indicative of gram (+) or gram (-) bacteria?Gram (-)
What are the three primary activities of endotoxin (lipid A)?(1) Stimulates macrophages --> IL-1 (fever), TNF, NO (vasodilation --> dec BP)
(2) Activates the alternative pathway of complement --> C3a & C5a --> inc histamine --> dec BP & exudation
(3) Activates factor 12 (hageman) of the coagulation cascade --> coagulation --> consumption of clotting components --> DIC
Which is more antigenic endotoxin or exotoxin? Which is more heat stable?Exotoxin; Endotoxin
memorize

Section 21.1 Major Exotoxins

Question Answer
What major exotoxin blocks glycine and GABA release? What is its effect?Tetanus toxin; Muscle spasms
What major exotoxin causes lockjaw, risus sardonicus, and eventually paralysis of respiratory muscles? What bacterium is it associated with?Tetanus toxin; Clostridium tetani
What major exotoxin blocks the release of Ach at neuromuscular junctions? What is its effect?Botulinum toxin; Muscle paralysis (flaccid)
What is the most potent exotoxin? What bacterium is it associated with?Botulinum toxin; Clostridium botulinum
What major exotoxin causes constipation followed by descending flaccid paralysis?Botulinum toxin
What major exotoxin features pharyngeal pseudomembrane development, myocarditis, and muscle weakness/paralysis? What bacterium is it associated with?Diphtheria toxin; Corynebacterium diphtheria
What three parts of the body are most affected by diphtheria toxin?(1) Throat (2) Heart (3) Neural tissue
What are the two bacteria that produce alpha toxin?(1) Clostridium perfringens (2) Staphylococcus aureus
Alpha toxin is produced by two different organisms. Which organism causes marked skin necrosis? Which organism causes marked necrosis of deep tissues?Staphylococcus aureus; Clostridium perfringens
What bacterium produces toxic shock syndrome toxin (TSST-1)? What is the mechanism of action of TSST-1?Staphylococcus aureus; Superantigen (binds directly to MHC II proteins)
What are the two super antigens produced by staphylococcus aureus?Toxic shock syndrome toxin (TSST-1) (2) Enterotoxin A-F
What major exotoxin binds to gangliosides in intestinal cell membranes? What is its effect?Cholera toxin; Massive watery diarrhea
What major exotoxin causes whooping cough? What bacterium is it associated with?Pertussis toxin; Bordetella pertussis
What is the only bacterial infection known to cause lymphocytosis?Pertussis (Whooping cough)
What are the two major enterotoxins produced by E. coli?(1) Heat labile (LT) - stimulates adenylate cyclase via binding to enterocyte gangliosides and Gs protein
(2) Heat stable (ST) - activates guanylate cyclase, resulting in in cGMP -> blockade of ion movement from intestinal lumen into enterocytes -> water is drawn into lumen by attraction to excess ions in lumen
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Section 22.0 O2-Requirements

Question Answer
Why are microaerophilic bacteria able to tolerate low levels of oxygen?Because they possess superoxide dismutase to deal with all the oxygen radicals they encounter (obligate aerobes have MANY enzymes to remove O2 radicals)
With regard to O2 requirements, the largest number of bacterial species belong to which group?Facultative ANAEROBES
What bacteria are obligate aerobes (5)? Identify their gram stain.Nagging Pests Must Breathe
-Nocardia (G+)/Neisseria (G-)
-Pseudomonas (G-)
-Mycobacterium (AFB)
-Bacillus (G+)/Bordetella pertussis (G-)
What bacteria are microaerophilic?Can Survive Small Breaths
-Campylobacter jejuni (G-)
-Streptococcus species (G+)
-Spirochetes (Treponema, Borrelia, Leptospira)
-Brucella abortus (G-)
What bacteria are obligate anaerobes?Can't Breathe Air
-Clostridium spp (G+)
-Bacteroides fragilis (G-)
-Actinomyces israelii (G+)
What O2 requirements do Staph spp and Corynebacterium diphtheriae have?Facultative anaerobes
What are important enzymes involved in neutralizing reactive oxygen species?Superoxide dismutase (O2 + O2 +2H+ -> H2O2 +O2)
Catalase (2 H2O2 -> 2 H2O + O2)
Glutathione peroxidase (2G-SH + H2O2 -> 2H2O + 2GSSG)
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