COMAT FBS Complete Study Guide Questions And Answers| Graded A+.

allergic rhinitis pathophysiology - correct answer APCs (dendritics) at mucosal surfaces present peptides from allergens to MHC-II = ligand for naive CD4 = Th2 activation and cytokine secretion / B cell isotype switching = IgE and eosino/mast/neutro proliferation IgE binds to mast cells / basophils allergic rhinitis early reaction - correct answer w/in 30min, type I HS IgE binds mast cells = secretes histamine, prostaglandins, leukotrienes allergic rhinitis late reaction - correct answer w/in 6hr via eosinophil chemotaxis ; inflamm cells/eosinos/masts/Ts break down and remodel nasal mucosa = nasal obstruction anaphylaxis mechanism - correct answer first exposure = IgE Abs second exposure = Ag's bind IgE Ab's on masts = large histamine release at CV, skin, lungs = severe O2 deficiency at brain hypersensitivity types - correct answer 1. IgE-mediated (allergies, asthma, anaphylaxis) 2. Cytotoxic ANTIBODY-mediated (IgM, IgG) (bullous pemphigoid, autoimmune hemolytic anemia, good pasture) 3. Immune COMPLEX-mediated (Ag-Ab) (SLE, arthus reaction, serums sickness) 4. Delayed-type T cell/MQ-mediated (allergic contact dermatitis , TB, transplant rejection) (5. Autoimmune RECEPTOR-mediated (IgM, IgG)) anemia mechanism - correct answer via blood loss that causes iron deficiency, hemolysis, or reduced erythropoiesis hypochromic microcytic anemia associated conditions - correct answer iron deficiency anemia thalassemia MINOR (only abn is Hb electrophoresis) lead poisoning (prominent basophilic stippling) chronic infection iron deficiency anemia - correct answer hypochromic microcytic, "cigar cells" milk babies high bilirubin w a high reticulocyte count relates to - correct answer hemolytic anemia thalassemia major - correct answer associated w severe hemolytic anemia hyperplasia/expansion of bones via increased marrow space to accommodate = RBC overproduction chronic hypoxia anesthesia mechanism - correct answer activate inhibitory CNS receptors (GABA[A]) inactivate excitatory presynaptic voltage-gated sodium channels in glutamatergic synapse anesthesia: associated receptors / agents (6) - correct answer activate GABA(A [a-1/BZ1 and a-2/BZ2) Cl- channels = hyperpolarizes = inhibits CNS NMDA receptor antagonist (ketamine) opioid rector agonists (Mu, kappa, delta) two-pore potassium channel (K[2P]s) activation = hyperpolarizes = inhibits CNS alpha-2 adrenergic receptor agonist (guanfacine, clonidine, tizanidine) dopamine receptor antagonists (antipsychs) four stages of anesthesia - correct answer 1: analgesia (motion / breathing reduced, amnesia, euphoria) 2: excitement (delirium, combative behavior, still reactive to touch) 3: surgical anesthesia (unconsciousness, loss of equilibrium, decreasing eye movement, NOT reactive to touch) 4: medullary depression / death (resp / cardiac depression / arrest, NO eye movement) what type of hypersensitivity is asthma - correct answer type I: IgE-mediated asthma pathophysiology - correct answer Type I IgE-mediated allergens/viruses/exercise = REVERSIBLE and RECURRENT SMOOTH MM spasms at SMALL bronchioles and increased mucus = airway restriction chronicity = airway remodeling (permanent structural changes in smooth mm/collagen) bullous pemphigoid - correct answer Type II cytotoxic antibody-mediated IgG autoAb's targeting DYSTONIN = anti-HEMIDESMOSOME Ab's = loss of KERATINOCYTES to basement membrane adhesion Candidiasis treatment - correct answer Fluconazole cellulitis pathophysiology - correct answer via GAS, S aureus, MRSA flora infects breaks through skin spread into fascial lining = necrotizing fasciitis S aureus = furuncles, carbuncles, abscesses chlamydia trachomatis treatment - correct answer Doxycycline (+ ceftriaxone for gonorrhea coinfection) azithromycin (for trachoma) contractions mechanism - correct answer non-pregnant (menstrual cycle): at sub-endometrial layer of estrogen/progesterone receptor-rich myometrium ; frequency increases toward ovulation, and decreases in luteal phase for possible implantation labor: via oxytocin positive feedback ; prostaglandins / inflamm mediators = encourage myometrial contractions and gap junction / connexin-43 expression coronary vasospasm is caused by what agents (3) - correct answer Cocaine sumatriptan ergot alkaloids coronary vasospasm pathophysiology - correct answer coronary aa is hyperreactive to vasoconstrictor stimuli (via endothelial dysfunction, chronic inflammation, oxidative stress, smooth mm hyper contractility / myosin light chain phosphorylation / Rho-kinase activation) (and smoking = vasospastic angina) = ischemia coronary vasospasm management - correct answer calcium channel blockers (verapamil, diltiazem) nitrates statins (atorvastatin, [etc.]-statin) cystic fibrosis pathophysiology - correct answer auto recessive = CFTR chloride channel gene mutation that anchors at (exocrine glands) lung, pancreas, sweat glands = thick mucus = CFTR misfolding / degradation = mucus plugging, fibrosis, cysts chronic cystic fibrosis infective spp - correct answer S aureus H influ pseudomonas ( = "mucoid pseudomonas" via interleukin 17) aspergillus / candida cystitis spp - correct answer (UTI) E coli klebsiella proteus cystitis treatment - correct answer trimethoprim-sulfamethexazole (or nitrofurantoin, cephies, FQs) coronary vasospasm is caused by what agents (3) - correct answer Cocaine sumatriptan ergot alkaloids coronary vasospasm pathophysiology - correct answer coronary aa is hyperreactive to vasoconstrictor stimuli (via endothelial dysfunction, chronic inflammation, oxidative stress, smooth mm hyper contractility / myosin light chain phosphorylation / Rho-kinase activation) (and smoking = vasospastic angina) = ischemia coronary vasospasm management - correct answer calcium channel blockers (verapamil, diltiazem) nitrates statins (atorvastatin, [etc.]-statin) cystic fibrosis pathophysiology - correct answer auto recessive = CFTR chloride channel gene mutation that anchors at (exocrine glands) lung, pancreas, sweat glands = thick mucus = CFTR misfolding / degradation = mucus plugging, fibrosis, cysts chronic cystic fibrosis infective spp - correct answer S aureus H influ pseudomonas ( = "mucoid pseudomonas" via interleukin 17) aspergillus / candida cystitis spp - correct answer (UTI) E coli klebsiella proteus cystitis treatment - correct answer trimethoprim-sulfamethexazole (or nitrofurantoin, cephies, FQs) delayed emergence - correct answer failure to regain consciousness 30 - 60min after general anesthesia = stroke, hypoxic-ischemic brain injury, status epilepticus, emergence delirium, sepsis, multi-organ failure via excessive dosing, decreased metabolism / clearance, inadequate drug reversal at end of surgery agents used to treat delayed emergence - correct answer naloxone for narcotics flumazenil for benzos neostigmine for neuromuscular blocking agents C diphtheria features / buzzwords - correct answer GPR, small, curved rods "chinese letters" exotoxin: via lyosgenic bacteriophage / beta-prophage = ADP-ribosylates EF-2 to inactive protein synth loeffler's (metachormatic blue/red) or tinsdale / tellurite (black colonies) = grey-white membrane, lymphadenopathy, myocarditis, CNS neuropathies, renal disease C diphtheria agar - correct answer loeffler's agar ( = metachromatic blue/red granules) tinsdale / tellurite ( = black colonies) C diphtheria vaccines - correct answer diphtheria toxoid (active) diphtheria antitoxin (passive) E. coli types - correct answer EPEC: watery, no toxins ; intimin / Tir (adhesion / receptor) ; type III secretion system = "P"edestal attachment ETEC: watery, TOXINS ; heat stabile toxin (guanylate cyclase = cGMP) ; heat labile toxin (AB toxins ; A subunit ADP-ribosylates G-protein = cAMP) = ions / water move out of cells to intestinal lumen EIEC: bloody, no toxins EHEC: bloody, TOXINS ; O157:H7 ; = HUS via VEROTOXIN at glomeruli (hemolytic anemia, uremia, thormbocytopenia / petechiae) ; intimin / Tir (shiga-like / verotoxin) ; common at resource-RICH epilepsy pathophysiology - correct answer genetics: mutations in ion channels, GABA, G protein-coupled rec (high in Angelman and Down syndrome) phakomatoses (neurocutaneous): e.g. neurofibromatosis type 1 via sturge-weber (GNAQ gene), tuberous sclerosis complex (TSC1/2 genes) acquired: trauma, herpes, cysticercosis (tanea solium), toxoplasmosis, toxocariasis