FA17 ADDITIONS GENERAL PRINCIPLES

BEHAVIOURAL SCIENCE:

1. Ph si ia s should seek i o s asse t e e if thei o se t is ot e ui ed

2. The Spouse ChiPS in Spouse > adult children > parents> adult siblings > other relatives
3. Pg45, #3 MC cause of death <1yr is Maternal Pregnancy complication (not SIDS)

BIOCHEMISTRY:

1. Protein synthesis occurs from N-terminus to C-terminus

2. PUMPKin Pump K+ in (Na/K Atpase)
3. Variable Expressivity Pt with same genotype have varying phenotype
4. Mosaicism If parents and relatives do not have the disease, suspect gonadal (germline) mosaicism
5. Edward syndrome PRINCE
P Prominent Occiput
R Rocker Bottom Feet
I Intellectual Disability
N Nondisjunction
C Clenched fists (overlapping fingers)
E Low set ears
6. Chromosome 17 p53
7. Supplemental maternal folic acid atleast 1 month prior pregnancy
8. Synthase/ Synthetase Combines 2 molecules into 1 (condensation reaction). If using energy synthase (ex:
Glycogen synthase); not using energy synthetase (PRPP synthetase)
9. MODY on chromosome 20
10. AMP inhibits Fructose-1,6-bisphosphatase
11. In Fructose metabolism, DHAP (dihydroxycetone-P) to Glyceraldehyde-3-P is by triose phosphase isomerase
enzyme {this point mentioned in figure}
12. I Met His Valentine, she is so Sweet Methio i e, Histidi e, Vali e, Glu oge i AA s s eet Esse tial AA s
13. His Lys (lies) Are Basic Histidi e, l si e, A gi i e a e asi AA s
14. HOMOCYstinuria
H increase homocysteine in urine
O Osteoporosis
M Marfanoid Habitus
O Ocular changes
C Cardiovascular defects
Y kYphosis
15. Pompe disease causes hypotonia
16. Rx for MCAD deficiency is to avoid fasting
17. Krabbe Disease Destruction of oligodendrocytes
18. Familial dysbetalipoproteinemia (Type III) AR inheritance; defect in ApoE; increased blood levels of
chylomicron and VLDL remnants; symptoms: premature atherosclerosis, tuboeruptive xanthomas

MICROBIOLOGY:

1. Hyaluronic acid capsule inhibits phagocytosis In Steptococcus Pyogenes

2. Tetanus Opistotonus (due to spasm of spinal extensors)
3. Symptoms of botulism D s Diplopia, D sa th ia, D sphagia, D sp ea
4. PPD negative if no TB infection, sarcoidosis, HIV infection (due to low CD4+ cell count)
5. Correction of Langerhans giant cells to Langhans giant cells (Pg124; first part; last before line)
6. Diagnosis of leprosy by skin biopsy and PCR assay
 7. Neisseria has LOS (lipooligosaccharide)
8. Neisseria causes neonatal ophthalmoplegia 2-5days after birth
9. EHEC does t fe e t So itol a d also does t p odu e glu u o idase
10. Shigella Invasion of M cells is the key of pathogenicity
11. Vibrio can be transmitted by contaminated drinking water and sea food
12. Lyme Disease Rx: Doxycycline (1st line); In Pregnancy and children Amoxicillin and Cefuroxime
13. Chlamydia causes neonatal conjunctivitis 1-2 weeks after birth (vs Neisseria neonatal conjunctivitis)
14. Tinea Versicolor has weak association with pruritis
15. Entamoeba histolytica Rx: Paromomycin (other drug name added to existing list)
16. Toxoplasma gondii Multiple ring enhancing lesions
17. Trichinella Spiralis Transmission mainly by undercooked meat (pork); Fecal-oral (less likely)
18. Echinococcus Granulosus Eggshell calcification
19. Transmission of Scabies is by direct skin-skin contact or formites
20. DNA viruses Po is out of the o Po does t epli ate i u leus
21. HSV Esophagitis, erythema multiforme
22. EBV confused with strep throat; differentiated by Amoxicillin which causes maculppapular rash in EBV
infection
23. Roseola Rosie later First fever, rash later ; HHV-7 less common cause of Roseola
24. Zika Virus Added to Flavivirus category
25. Chicken Guniya virus Added to Togavirus category
26. West Nile virus causes meningioncephalitis
27. Use PCR in neonates to detect HIV viral load
28. Listeria Monocytogenes Deli meats, soft cheese
29. Staph saphrophyticus Urease Positive
30. Measles confluent rash
31. Rubella Rash remains discrete
32. Avibactum (added to beta lactamase inhibitors)
33. 3rd Gen Cephalosporins cross BBB
34. Doxycycline affective against MRSA
35. Fluoroquinolones clinical use Otitis Externa
36. Isoniazid Anion Gap metabolic acidosis
37. Influenza therapy start within 48hrs of influenza symptom onset
38. ifa pi o t ai di ated ith PI s. epla e ifa pi ith ifa uti

IMMUNOLOGY:

1. Thymoma associated with Myasthenia Gravis, SVC syndrome

2. MHC I 1 long change, 1 short chain; MHC II 2 long chains
3. Th1 cells secrete IL-2; Th2 cells secrete IL-6 (in addition to other points mentioned already in book)
4. Nave T cell activation 2nd signal: B7 proteins on dendritic cell (CD80/86) and CD28 on nave T cell
5. CD55 Decay Accelerating Factor
6. TNF-alpha maintains granuloma in TB
7. IL-1, IL-6, TNF-alpha can mediate sepsis
8. Passive immunity Diphtheria antitoxin (extra point)
9. MMR and varicella can be given to HIV pts with CD4+ count >200
10. Allergic reaction within minutes to 2-3hours
Anaphylactic reactions within minutes to 2-3 hours
Febrile nonhemolytic transfusion reaction 1-6hours
Acute hemolytic transfusion reaction within 1 hour
11. Islet ell toplas i A s DM type 1
12. Antisynthetase (Anti Jo-1) Ab; Anti helicase (Anti Mi-2) Ab; Anti SRP Polymyositis, dermatomyositis
13. MPO-ANCA Ulcerative colitis (extra added)
 14. A ti gl op otei Antiphospholipid syndrome
15. Live vaccine contraindicated in Bruton agammaglobulinemia
16. Ataxia telangiectasia Increased risk of lymphoma and leukemia
17. Hyper IgM syndrome Failure to make germinal centers
18. Corticosteroids Adverse effect: Adrenal insufficiency, Asthma, CLL, Non Hodgkin lymphoma (Pg212);
De a gi atio og WBC s ause a tifi ial leu o tosis
19. Romiplostim Thrombopoietin Analog
Eltrombopag Thrombopoietin Receptor Agonist
20. IFN- li i al uses: Hai ell leuke ia, CC, o d lo a a u i ata e t a added
21. Bevacizumab clinical use Non Small cell lung cancer (extra added)
22. Ustekinumab Target: IL-12/Il-23; Clinical use: Psoriasis, psoriatic arthritis {NEW DRUG}
23. Ranibizumab clinical use Proliferative diabetic retinopathy, macular oedema

PATHOLOGY

1. Fibrinoid necrosis seen in PAN, Preeclampsia, Malignant HTN (extra added); Type III HS
2. Free Radical injury Reperfusion injury after thrombolytic therapy (example added)
3. Hypertrophic scar Type III collagen; Keloid Disorganized types of I and III collagen
4. Proliferative phase of wound healing Delay due to vit C and Cu def
5. Remodeling phase of wound healing Delay due to Zn def
6. High stage and low grade tumor is worse than low stage and high grade tumor
7. Paraneoplastic Cerebellar degeneration Antibodies against antigens in Purkinje cells
Anti-Hu antigens Small cell lung cancer
Anti-Yo antigens Gynec and breast cancer
Anti-Tr antigens Hodgkin lymphoma
8. Tumor Suppressor genes:
APC egati e egulato of -cantenin/WNT pathway
PTEN Tyrosine phosphate of PIP3 (Protein kinase B [AKT] activation)
WT1 Transcriptional factor that regulates urogenital developments
9. ALP exclude hepatic origin by checking LFTs and GGT levels
10. PSA surveillance marker for recurrent disease after prostatectomy

PHARMACOLOGY:

1. Warning! These Drugs Are Lethal:

Warfarin; Theophylline; Digoxin; Lithium Low therapeutic index
2. Adrenal medulla directly innervated by preganglionic sympathetic fibers
3. Mirabegron A tio o Use: Urinary urge incontinence or overactive bladder {NEW DRUG}
4. Bisoprolol added to sele ti e a tago ist d ugs
5. Osteoporosis GnRH anlogs, DMPA, aromatase inhibitors, anticonvulsants (extra added)
6. Fanconi syndrome Cisplatin, expired tetracyclins (extra added)
7. Interstitial nephritis Proton pump inhibitors (extra added)

NOTE:

Co plete e fa ts ill e fou d i the othe pdf titled FA Cha ges . These a e o l the i o ut i po ta t
additio s o th e tio i g ade to the FA e sio . I ha e ot e tio ed a of the o t o e sial poi ts i this
list, neither the sa e FA poi t itte ith diffe e t o ds i FA . If ou do o e a oss a e t a poi ts,
please do let me know.

Dhakshitha