Distinguish between thymus-independent and thymus-dependent antigens.
Thymus-independent: lack a peptide component and thus cannot be presented by MHC to T cells, stimulate release of IgM antibodies only and do not result in immunologic memory; thymus dependent: contain a protein component and thus induce class-switching and immunologic memory
Name the 3 macrophage acute phase cytokines.
IL-1, IL-6, TNF-α
Describe the use of recombinant α-, β-, and γ-interferon.
Describe the equations for odds ratio (OR), relative risk (RR), and attributable risk (AR).
OR = ad/bc; RR = [a/(a+b)]/[c/(c+d)]; AR = [a/(a+b)]-[c/(c+d)]
What is Number Needed to Treat (NNT)? What is the equation?
Number of patients you would need to treat in order to save/effect one life; NNT = 1/absolute risk reduction
How are prevalence and incidence of a disease related to the chronicity of the disease?
Prevalence > incidence for chronic diseases; prevalence = incidence for acute diseases
Differentiate between the Pygmalion and Hawthorne effect as they relate to study bias.
Pygmalion effect: occurs then a researcher's belief in the efficacy of a treatment changes the outcome of that treatment; Hawthorne effect: occurs when the group being studied changes its behavior owing to the knowledge of being studied
Differentiate between mean, median, and mode.
Mean: average of values; median: divides the frequency of distribution in half; mode: value of greatest frequency
Differentiate between a positively and negatively skewed statistical distribution.
Positive skew: mean > median > mode, asymmetry w/ tail on the right; negative skew: mode > median > mean, asymmetry w/ tail on the left
Odds ratio approximates relative risk if disease ______ is not high.
Differentiate between random and systemic error.
Random error reduces test precision; systemic error reduces test accuracy
What is the equation for standard error of the mean (SEM)?
SEM = σ / √n, where σ = standard deviation and n = sample size
What is the equation for confidence interval (CI)?
CI = mean ± Z(SEM), where Z = 1.6 for 90%CI, 2 for 95%CI and 2.5 for 99%CI
What is the purpose of chi-square tests?
Check difference between 2 or more percentages or proportions of categorical outcomes (not mean values)
Describe the PDR mnemonic as it relates to disease prevention.
Prevent; Detect; Reduce disability
Supplementation w/ what vitamin should be avoided in smokers?
Vitamin A, as it increases risk for lung cancer
What are the 5 leading causes of death in the U.S. for patients 1 - 14 years of age?
NO activates guanylate cyclase, which produces cGMP and triggers smooth muscle relaxation by facilitating the dephosphorylation of myosin light chains
What 3 coronary structures are derived from the sinus venosus?
Smooth part of right atrium; coronary sinus; oblique vein of left atrium
The smooth parts of the right and left ventricles are derived from the _____.
Differentiate between the uses of Pearson correlation coefficient, chi-square, t-test, and ANOVA.
Pearson correlation: interval data; chi-square: nominal data; t-test: combination of interval and nominal data w/ 2 groups only; ANOVA: combination of interval and nominal data w/ > 2 groups
What translocation is associated w/ follicular lymphoma?
t(14;18) leading to activation of bcl-2, which produces a protein that inhibits apoptosis
To where do the inferior and superior rectal veins drain?
Inferior rectal vein: IVC; superior rectal vein: portal system
Describe steroid myopathy due to Cushing disease/exogenous steroid use.
Proximal muscle weakness; muscle biopsy demonstrates selective atrophy of type II muscle fibers
In what 2 conditions is the presence of schistocytes common?
DIC; prosthetic heart valves
What is the initial drug of choice to treat symptomatic hypertrophic cardiomyopathy?
β-blockers, such as metoprolol
What is graft vascular disease?
Late and serious complication of heart transplantation; characterized by intimal thickening of the coronary arteries, resulting in progressive stenosis of the lumen; cannot be prevented w/ current immunosuppressant therapy
What is a common cause of first trimester pregnancy loss? Second/third trimester loss?
First trimester: chromosomal abnormalities; second trimester: chorioamnionitis; third trimester: abruptio placentae, placenta previa, chorioamnionitis
Qualitatively describe the levels of iron, ferritin, and transferrin in iron deficiency anemia.
Salivation (parotid gland); taste and tactile sensation of the posterior 1/3 of the tongue; tactile sensation from external ear, pharynx, middle ear; input from carotid body/sinus; motor efferents to stylopharyngeus muscle
Hirano bodies are associated w/ what neurodegenerative disease?
What are Lewy bodies? W/ what diseases are they associated?
Round, eosinophilic, intracytoplasmic inclusions seen in dopaminergic nigrostriatal neurons; Parkinson disease
What 3 drugs can be used during pregnancy to treat chronic hypertension?
Methyldopa; labetalol; nifedipine
What is the treatment for Klebsiella pneumonia.
3rd generation cephalosporin with or without an aminoglycoside
What cell type is infected by Babesia microti?
What test is used as a confirmatory test for HIV? How is the test interpreted?
Western blot; positive when results show antibodies to at least 2 of the 3 HIV antigens (gp24, gp41, gp120)
An indeterminate HIV Western blot is followed by a _____.
HIV polymerase chain reaction (PCR)
Describe the serologic tests used to diagnose Mycoplasma pneumoniae infection.
Presence of one or both of the following antibodies: cold agglutinins (autoantibody to O-positive red blood cells in cold), streptococcal MG agglutinins (antibodies against Streptococcus salivarius strain MG)
What is the most common cause of nephrotic syndrome in adults? The second most common cause?
What nerve is closest to the pituitary gland within the cavernous sinus?
Abducens nerve (CN VI)
What disease is transmitted by the Aedes aegypti mosquito? Describe its clinical course.
Yellow fever; high fever, jaundice, epistaxis, anuria, and hematemesis
Describe cri-du-chat syndrome.
Due to a terminal deletion of 5p; congenital abnormalities include catlike neonatal crying, microcephaly w/ dysmorphic facial features, cardiac defects (e.g., VSD), hypotonia, and severe mental retardation
What are Russell bodies?
Abnormal plasma cells containing accumulations of IgG immunoglobulin found in bone marrow biopsy of patients w/ multiple myeloma
What is the most common bacterial STD in the U.S.?
Chlamydia trachomatis (serotype D-K)
What hand muscles are NOT supplied by the ulnar nerve?
3 thenar compartment muscles; 1st and 2nd lumbricals
How are the 4th and 5th digit affected by a lesion of the ulnar nerve at the elbow versus a lesion at the wrist?
Elbow: completely extended; wrist: ulnar "claw hand", hyperextension of the 4th and 5th MCP joints w/ flexed 4th and 5th PIP/DIP joints
(T/F) Release of aldosterone is mediated by ACTH levels.
False; aldosterone is relatively independent of ACTH because it is controlled by angiotensin II and plasma potassium levels
What are the most frequent immediate causes of death of patients w/ paroxysmal nocturnal hemoglobinuria (PNH)?
Thrombosis and thromboembolism, w/ the intrahepatic veins being a common site for thrombosis (producing Budd-Chiari syndrome)
What types of cells are diagnostic of human papilloma virus (HPV)?
Koilocytic cells; cells w/ enlarged nuclei and perinuclear cytoplasmic vacuolization
What is the mechanism of estrogen in treating osteoporosis?
Inhibition of osteoclastic resorption and stimulation of bone deposition by osteoblasts so that bone density and mass increase
What structure is weakened in an indirect inguinal hernia?
Describe the affinity of epinephrine for α1 and β2 receptors.
Physiologically, epinephrine has a higher affinity for β2 receptors than α1 receptors
What autonomic receptors are present in the uterus? What does each mediate?