5 Heart Block *6 Low Complement • Insulin 1 dose Tx for

(LSD Loves Company) Associated Nephrotic Hookworms Chlamydia

• Lyme Disease Syndromes • Necatur Americanis Azithromycin
• Salmonella • Serum Sickness • Enterobius
• Diptheria • SLE Vermicularis “Big Mama” Anaerobes
• Legionella • SBE • Ankylostoma • Strep. Bovis
• Chagas’ • PSGN Duodenale • Bacteroides fragilis
• MPGN II • Trichuris Trichurium • C. melanogo-septicus
Reiter’s Syndrome • Cryoglobulinemia. • Ascaris Lumbricoides • C. difficile
(SYCIC with sore joints) • Strongyloides
• Shigella Induce P450 *If blood cultures show
• Yersinia (BAG for CpR QTS) X-linked Enzyme S. bovis or C. melanogo-
• Crohn’s • Barbiturates Deficiencies septicus = rule out colon
• IBD • Alcohol (Fabry and Lesh go cancer.
• Chlamydia • Griseofulvin Hunting for Candy, Pie
• Carbamazepine and Gum) Tx for “Big Mama”
Low Complement Bugs • Rifampin • Fabry’s anaerobes
(I AM HE) • Lesch-Nyhan • Metronidazole
• Quinidine
• Influenza • Tetracyclines • Hunter’s • Clindamycin
• Adenovirus • CGD (NADPH) • Cefoxitin
• Spironolactones
• Mycoplasma • Pyruvate DH
• Hep B & C • G6PD Serum Values for Low
Inhibit P450
Volume State
• EBV (I’D SMACK Quin)
• INH Screen Newborns • K - ↓
(Please Check Before • Na - ↓
Drugs Induced SLE • Dapsone
(HIPPPE) Going Home) • Cl - ↓
• Sulfa Drugs
• Hydralazine • Macrolides • PKU • pH - ↑
• INH • Congenital Adrenal • BP - ↑
• Amiodarone
• Procainamide • Cimetidine Hyperplasia
• Penicillamine • Biotidinase 1 dose Tx for
• Ketoconazole
• Galactosemia Gonorrhea
• Phenytoin • Quinolones
• Hypothyroidism • Ceftriaxone
• Ethosuximide
• Cefixime
P450 Dependent
Drugs that blast BM Action of Steriods • Cefoxitin
(WEPTeD)
• AZT • Warfarin (KIIISS) • Ciprofloxacin
• Benzene • Kills T-cells and • Ofloxacin
• Estrogen
• Chloramphenicol Eosinophils • Gatifloxicin
• Phenytoin
• Vinblastin • Theophylline • Inhibit MӨ migration
• Inhibit Phospholipase Psammoma Bodies
• Digoxin
Comma Shaped Bugs A • Papillary CA of
• Inhibit mast cell Thyroid
• Vibrio SE of Statins
degranulation • Serous Cystadenoma
• Campylobacter • Myositis
• Stabilizes endothelium of ovary
• Listeria • Hepatitis
• Stimulates protein • Meningioma
• H. pylori • ↑ Liver enzymes
synthesis • Mesothelioma
Chinese Letters Painful Genetial
Corynebacter Causes of Severe Drugs that Cause
Lesions
Monocytosis (STELS) Cardiac Fibrosis
• Herpes
Crescent Shaped • Salmonella • Adriamycin
• Chancroid (H.ducreyi)
Protozoa • TB • Phen-Fen
• Lymphogranuloma
Giardia Lamblia venereum • EBV
• Listeria Indication for PUD
• Lymphogranuloma surgery
TB Treatments inguinale • Syphilis
(RESPI) • (IHOP)
• Rifampin Macrolides • Intractable Pain
Disulfide Bonds
• Ethambutol • Azithromycin • Hemorrhage
(PIGI)
• Streptomycin • Clarithromycin • Obstruction
• Prolactin
• Pyrozinamide • Erythromycin • Perforation
• Inhibin
• INH • GH
1
 • Sydenham Chorea • Tricuspid Regurg. • Ceftriaxone – 250mg
Urease +ive Bacteria • Ventricular Septal IM
(PPUNCHES) IgA Nephropathies Defect
• Proteus • Henoch-Schoenlein Dihydrofolate 1 Dose Tx –
• Pseudomonas Purpura (HSP) Reductase Inhibitors Gardnerella
• Ureaplasma • Berger’s • Pyremethamine/Sulfad Metronidazole
urealyticum • Alport’s iazine
• Nocardia • Trimethroprim/Sulfam SE of Thiazides and
• Cryptococcus Massive Eosinophilia ethoxazole Loop dieuretics
neoformans • (NAACP) • Methotrexate • Hyperglycemia
• H. pylori • Neoplasms • Hyperuricemia
• S. saprofiticus • Allergies/Asthma Sulfa Containing Drugs • Hypovolemia
• Addison’s • Sulfonamides • Hypokalemia
Drugs that Cause • Collagen Vascular • Sulfonylureas
Pulmonary Fibrosis Disease • Celecoxib (COX2 MӨ in Various Tissues
(BBAT) • Parasites inhibitor) Brain…………Microglia
• Bleomycin Lung……Type I Pneumo
• Busulfan Risk Factors for Silver Staining Bugs Liver……….…...Kupffer
• Amiodarone Primary Liver Cancer • Legionella Spleen………..RES cells
• Tocainide • Hep B and C • Pneumocystis Kidney………Mesangial
• H. pylori LN……………Dendritic
• (methotrexate & • Aflatoxin
Skin……...…Langerhans
cormustine) • Vinyl Chloride • Bartonella henselae
Bone……..…Osteoclasts
• Alcohol • Candida
CT………..…Histiocytes
Salmonella Typhi • Carbon Tetrachloride ………...…Giant cells
• High fever • Anyline dyes Blood Gas w Restrictive
..…………Epithelioid
• Rose spots • Smoking Lung Disease
• Intestinal fire • Hemochromatosis • Tachypnea
Rashes of Palm & Soles
• Monocytosis • Benzene • ↓ pCO2 (TRiCKSSSS)
• Heart block • Schistosomiasis • ↓ pO2 • TSS (Toxic Shock)
• ↑ pH • Rocky Mt. Spotted
Drugs that cause 9 Live Vaccines Fever
Myositis • Measles Blood Gas with • Coxsackie A (Hand,
(RIPS) • Mumps Obstructive Lung Foot & Mouth Dis.)
• Rifampin • Rubella Disease
• Kawasaki
• INH • Oral Polio • ↑ or Normal pO2
• Scarlet Fever
• Prednisone • Rotavirus • ↑ pCO2
• Syphilis
• Statins • Small Pox • ↓ pH
• Staph. Scalded Skin
• BCG • Streptobacillus
Encapsulated Bacteria MI – Enzymes
• Yellow Fever moniliformis
(Some Strange Killers Troponin I
• Varicella
Have Pretty Nice - appears 2 hrs
-peaks 2 days 4 Sources of Renal Acid
Capsules)
Autoimmune Hemolytic -gone 7 days • Plasma (RTA)
• Strep. Pneumo (gr. +)
Anemia • Ammonia production
• Salmonella
• PTU CKMB -appears 6 hrs in the collection duct –
• Klebsiella
• Cephalosporins -peaks 12 hrs 10% of Urea Cycle
• H. Flu B
• α-methyldopa -gone 2 days • Glutaminase
• Pseudomonas
• Sulfa drugs • Carbonic Anhydrase
• Neisseria • Anti-malarials LDH -appears 1 day
• Citrobacter Hormones Produced by
• Penicillin -peaks 2 days
-gone 3 days Small Cell CA of Lung
Encapsulated Yeast • ACTH (MC)
Autoimmune
Cryptococcus
Thrombocytopenia MӨ Deficiency • ADH
• Aspirin • Chediak-Higashi • PTH
Jones Criteria for ARF
• Heparin • NADPH-oxidase def • TSH
(J♥NES)
• Quinidine • ANP
• Polyarthritis (joints)
1 Dose Tx for H.ducreyi
• Carditis (♥)
Pansystolic Murmurs • Azithromycin – 1gram 1 Dose Tx - Candidiasis
• Nodules subcutaneous
• Mitral Regurg. Ketoconazole – 150mg
• Erythema marginatum
2
1 Dose Tx – Vaginal • Pregnancy • Hyperkalemia • Strep. Pneumoniae
Candidiasis • I.V. Fluids • Hyponatremia (aka pneumococcus)
Diflucan – 1 pill • ASD (fixed split) Staph. Epidermiditis
• Deep breathing Hormones produced by Most common infection
1 Dose Tx - the Placenta of shunts and central
Trichomonas Cavities of Blood Loss • hCG lines
Metronidazole • Pericardium • Inhibin
Viruses Related to CA • Intracranial • Human Placental How do you tell
HPV…..Cervical cancer Lactogen Catalase positive
• Mediastinum
EBV…..Lymphoma • Oxytocin Staphylococci apart?
• Pleural cavity
HVB…..Liver carcinoma • Progesterone (by pigment)
• Thighs
HVC…..Liver carcinoma Aureus…………....gold
• Retropritoneum • Estrogen
HIV……Kaposi Epidermidis……...white
• Abdominal Saprophyticus….…none
• Pelvis Uses for Pilocarpine
NM Disease Concept
• Cystic Fibrosis
• Restrictive Blood Gas Strep. pyogenes
Negative Stranded RNA • Closed angle
• ↓ pO2 ↓pCO2 ↑ pH • MCC: all throat
• 1-3 week prodromal Glaucoma
• ↑ RR infections,
period before SX lymphangitis,
• ↑ Risk for Seizures Cause Dysguzia
• Must switch to impetigo, necrotizing
• ↓ Pulmonary Capillary • Metronidazole
positive stranded faceitis, erysipelas,
Wedge pressure
before it can replicate • Clarithromycin Scarlet fever
• Zinc deficiency • 2nd MCC: all other
PIE Syndrome
Positive Stranded RNA skin infections
(Pulmonary Infiltrate
• Symptoms occur Carcinoid Triad
with Eosinophillia)
within 1 week or less • Flushing Neutrophil Deficiencies
• Necator Americanus
• Don’t have to switch • Wheezing • Job-Buckley Syn.
• Ascaris Lumbricoides
before replicating • Diarrhea • NADPH Oxidase
• Schistosomiasis
• Exceptions – Hanta, defic.
• Strongyloides
Ebola and Yellow **Dx by measuring 5- • Neutropenia
• Ankylostoma Fever which are HIAA in the urine**
• Myeloperoxidase
negative stranded **Most common primary
Emzymes that use B12 defic.
location = appendix**
• Methyl Malonyl CoA Cyanotic Heart **Most common
mutase Compartment
Diseases metastatic location =
• Homocystine methyl Syndrome
• Transposition of great pancreas, ileum**
transferase • Pain (always first)
arteries
• Pallor
• Tetralogy of Fallot AVMs
Increased Susceptibility machinery murmur • Poikilothermia
• Truncus Arteriosus
to Pseudomonas and S. • Heart: PDA • Parasthesia
• Tricuspid Atresia
aureus • Elbow: dialysis fistula • Pulselessness (always
• Total Anomalous
• Burn patients • Brain: Von Hippel- last)
Pulmonary Venous
• Cystic Fibrosis Lindau
Return Itchiest Rashes
• Diabetes • Lungs:Osler-Weber-
• Hypoplastic Left Heart • Scabies
• Neutropenics Rendu
Syndrome
• Lichen planus
• Ebstein’s Anomaly
Crohn’s Disease Hemophilus Influenza • Urticaria
• Aortic Atresia
(“GIFTS”) • Gram negative rods • Dermatitis
• Pulmonic Atresia
• Granuloma • Pleomorphic herpetiformis
• Illeum • “School of Fish”
LL to Depolarize Oddities About Listeria
• Fistula • Type A = non-
• Hypermagnesemia • Only gram positive w/
• Transmural encapsulated, non-
• Hypercalcemia (except endotoxin
• Skip Lesions invasive, MCC of
Atrium) • Crosses placenta
• Hypokalemia sinusitis, otitis,
Causes of Widened S2 bronchitis • Lipid A is toxic part
• Hypernatremia • Causes granulomas
• ↑ pO2 • Type B= encapsulated,
• ↑ volume Rt. Ventricle invasive, IgA protease, • Causes sepsis in
ML to Depolarize neonates
• Blood transfusion • Hypomagnesemia MCC of epiglottitis
• Supplemental O2 • Raw cabbage, spoiled
• Hypocalemia (except milk
• Rt. sided heart failure atrium) Rust Colored Sputum

3
B Vitamins Heart Block Clue Types of Kidney Stones
B1 – Thiamine • Increased body 5 Causes of SIADH • Calcium oxalate - 80%
• Beriberi temperature with a (SIADH) • Struvite
• Wernicke’s normal heart rate. • Small Cell Carcinoma • Uric Acid
• Korsakoff • ↑ intracranial pressure • Cysteine
B2 – Riboflavin • HR should increase by • A Pain • Oxalate
• Angular stomatitis 10bpm for every 1 • Drugs
B3 – Niacin degree increase in • Hypoxia Pseudogout
• Pellagra temperature • Ca++ pyrophosphate
• 4 d’s Cells of Neural Crest • + birefringent crystals
B4 – Lipoic acid Macrophages Origin • Rhomboid crystals
B5 – Pantothenic acid Release MHC II (POT CLAMPS) • MC older patients
B6 – Pyridoxine • Parafollicular cells • Seen equally in both
• seizures TH1 Secrete • Odontoblast genders
B9 – Folate • IL-2 • Tracheal cartilage • Tx = Colchicine
B12 – Cobalamine • IF-γ • Chromaffin Cells
• pernicious anemia • Laryngeal cartilage MC Non-cyanotic
• neuropathy TH2 Secrete • All Ganglion cells Congenital Heart Dis.
• IL-4 • Melanocytes • VSD
Periods of rapid growth • IL-5
• Pseudounipolar cells • ASD
• Birth – 2 months • IL-6
• Spiral membrane (♥) • PDA
• 4 – 7 years • IL-10
• Coarctation of aorta
• Puberty Ions and the EKG
TH0 Secrete P-wave = Ca++ Enzymes NEVER seen
Only Immune • TH1 QRS complex = Na+ in Glycolysis
Deficiency with Low • TH2 S-T Interval = Ca++ Pyruvate carboxylase
Calcium T-wave = K+ PEP carboxykinase
DiGeorge’s Syndrome T-Cytotoxic Cells U-wave = Na+ Fructose-1,6-phosphatase
• CD-8 positive Glucose-6-phosphatase
Bugs with IgA Protease • CD-4 negitive Maximum Sinus Rate
• S. Pneumonia • Recognize MHC I 220-age in years Enzymes ONLY seen in
• H. Influenza • Also have markers Glycolysis
• Neisseria CD-2 and CD-3 Tri-Nucleotide Repeats Hexokinase
(are resistant to IgA) • Huntington’s Phosphofructokinase-1
T-Helper Cells • Fragile X Pyruvate kinase
Secretions of Mast Cells • CD-4 positive • Myotonic dystrophy
• Histamine • CD-8 negative • Spinal/bulbar Acid Fast Organisms
• Slow Reacting • Recognize MHC II muscular atrophy • Mycoplasma
Substance of • Also have marker CD- (rare) • Nocardia (partially,
Anaphylaxis 2 and CD-3 gr+)
• Eosinophil Low volume states with • Cryptosporidium
Chemotactic Factor of Elevated Cholesterol acidosis (not alkalosis) (partially, protozoa)
Anaphylaxis • Xanthomas on • RTA
extensor surfaces • Diarrhea Microsteatosis Causes
Secretions of Eosinophil • ↑ risk for CAD • Acetaminophen
• Histaminase MCC Croup & • Reye Syndrome
• Arylsulfatase Elevated Triglycerides Bronchiolitis • Pregnency
• Heparin • Xanthelasmas on • Parainfluenza
eyelids and face • RSV (ER this is #1) Macrosteatosis Causes
Actions of E.coli • ↑ risk of Pancreatitis • Adenovirus • Alcohol
• Secrete Vitamin K • Influenza
• Secrete Biotin 4 Causes of Severe Pain Bacteria with Elastase
• Secrete Folate • Pancreatitis (EtOH) 4 D’s of Pellagra • Staph. aureus
• Secrete Pantothenic • Kidney Stones (bloody • Dermatitis • Pseudomonas
acid urine) • Diarrhea
• Aids in absorption of • AAA (ripping, tearing • Dementia Bacteria with toxins
B12 pain) • Death that inhibit EF-2
• Ischemic Bowel • Pseudomonas
(bloody diarrhea) • Diphtheria

4
Phage Mediated Toxins Gram Positive Spore
(Oh BED) Formers Group D Streptococcus MCC of Newborn
“O” antigen (Salmonella) • Bacillus anthracis Viridans – green pigment Meningitis
Botulinum • Clostridium perfrigens – SBE • Group B Strep
Erythrogenic toxin • Clostridium tetani Mutans – Cavities • E. coli
Diphtheria Sanguis • Listeria
Used for Cold Salivaris
Segmented Viruses Agglutinin Testing Bovis Bacteria Accociated
(I sprayed ORTHO on Strep. salivarius with Colon Cancer
BUNYA at the ARENA Nephritic Syndrome • C. melanogosepticus
down in REO to kill Drugs that Cause • Hypertension • S. bovis
SEGMENTED worms) Disulfiram Reaction • Hematuria
• Orthovirdiae • Chlorpropamide • RBC casts Gram – that are strict
• Buny, Arena, Reo • Lactams Anaerobes
• Antabuse Nephrotic Syndrome H. flu
Functions of Adhesion • Metranidazole • Edema Neisseria
Molecules • Hyperlipidemia
• Lymphocytes homing 3 Toxins of Bacillus • Hypercholesterolemia Pre-renal Failure
• Inflammation • Lethal factor • Hypercoagulability Serum BUN > 20
• Cell-cell interaction • Protective factor • ↓ serum albumin Serum Cr > 40
• Edema factor • ↑ urine albumin Fractional Na exc. < 1%
Esophageal/Gastric CA
Risk Factors Beta Blockers MCC of Airway Renal Failure
• Smoking B1 Selective: A-M Infection Serum BUN ~ 10 to 15
• Alcohol (except C & L) (sinusitis, otitis, Serum Cr < 20
• Nitrates Nonselective: N-Z, C, L bronchitis, pneumonia) Fractional Na exc. > 2%
• Japanese #1 – S. pneumonia
Fanconi Syndrome #2 – H. influenza Extravasation
Bladder CA Risk • Defect in proximal #3 – N. meningitides • Pavementing
Factors tubule • Margination
• Smoking • Can’t reabsorb Gastroenteritis within 8 • Diapedesis
• Aniline dyes • Low energy state hours of eating • Migration
• Benzene • Can be caused by old (pre-formed toxin)
• Aflatoxin tetracycline • S. aureus (potato If Cell Mediated is
• Cyclophosphamide salads) defective – tx for
• Schistosomiasis Glutaminase • C. perfringens • Viral
• Von Hippel-Lindau • In collecting duct (holiday turkey/ham) • Fungal
• Tubular Sclerosis • Absorbs ammonia in • B. cereus (fried rice) • Mycobacterium
the liver • Protozoa
Structures with No • Cause of hepato-renal Citrobacter • Parasite
Known Function syndrome Cause of multiple • Neoplasm
• Appendix cerebral abscesses in
3 Anatomical newborns Herpes Viruses
• Epithalamus
• Palmaris longus Narrowings of Ureter • I – oral
• Hilum MCC of UTI • II – genital
• Pancreatic Polypeptide
#1 – E. coli • III – varicella zoster
• Pelvic Brim
#2 – Proteus
Progressing to RPGN • Entrance of bladder • IV – EBV
#3 – Klebsiella
• Goodpasture’s (#1) • V – CMV
• Diabetes Mellitis Odd MCC of Death • VI – Roseola
Most Frequent in
• Hypertension SLE, endometrial and • VII – Pityriasis rosea
Females 5-10 yrs and
• Wagener’s cervical cancer – renal • VIII – Kaposi’s
18-24 yrs
failure
S. saprophyticus b/c they
Causes of Papillary stick things inside Disease Picked up
Necrosis Methotrexate Uses During Delivery
themselves
• Vasculitities • Dx Fragile X • Group B strep
• AIDS • Tx Molar Pregnancy S. aureus • S. pneumonia
• Tx Fast growing CA MCC of osteomyelitis • Herpes
• Tx Steroid resistant MCC of infection in burn • N. gonorrhea
disease patients • Chlamydia

5
T & B-cell Deficiencies Amino Acid Abbreviations
• WAS – Thrombocytopenia, IL-4, Eczema, ↓ IgM
• SCID – Adenosine deaminase deficiency, T> B, Glycine Gly Threonine Thr
frameshift/nonsense mutation, ↑ bacterial & fungal infx. Alanine Ala Cysteine Cys
• CVID – Tyrosine kinase deficiency, Late onset, Valine Val Tyrosine Tyr
frameshift/missense mutation Leucine Leu Asparagine Asn
• HIV (HTLV-1) – Effects CD-4 rich tissues (brian, Isoleucine Iso Glutamine Gln
testicles, cervix, rectum, blood vessels), T>B Methionine Met Aspartic Acid Asp
• Job-Buckley Syndrome – red headed female, Tyrosine Phenylalanine Phe Glutamic Acid Glu
kinase deficiency Tryptophan Trp Lysine Lys
Proline Pro Arginine Arg
B-Cell Deficiencies Serine Ser Histidine His
• Bruton’s Agammaglobulinemia – Tryosine kinase
deficiency Amino Acids Subgroups
• Leukemias • Acidic: Asp Glu
• Lymphomas • Basic: Arg Lys
• See above for those with T-cell overlap
• Make Disulfide Bonds: Cys Met
T-Cell Deficiencies • O-Bonds: Ser(90%) Thr Tyr
• DiGeorge’s – hypokalemia, problem with 3rd and 4th • N-Bonds(extra NH2): Asp Gln
pharyngeal pouches, deletion of chromosome 22
• HIV • Branched: Leu Iso Val
• See above for those with B-cell overlap • Bulky (Aromatic): Phe Tyr Trp

Electron Transport Chain • Smallest: Gly

• Poisons • Responsible for Bends: Pro
Complex I…….Amytal, Rotenone • CNS excitatory: ASP
Complex II……Malonate • Make Catecholamines: Tyr
Complex III…..Antimycin
Complex IV…..CN, CO, Chloramphenicol • Ketogenic: Lys Leu
Complex V……Oligomycin
• Gluco-& Ketogenic: Phe Iso Thr Trp
• Chemical Uncouplers
• Glucogenic His Arg Glu Asp Gln
DNP
Asn Tyr Cys Pro Met
Free Fatty Acids
Val Ala Gly
• Physical Uncouplers
Aspirin Essential Amino Acids
(PVT TIM HALL)
Places where Amino Acids feed in/out of TCA Cycle Phe Trp His
• Pyruvate…………..Gly, Ala, Ser Val Iso Arg
• Acetyl CoA……….Phe, Iso, Thr, Tyr, Lys, Leu Thr Met Leu
• α-ketogluterate……Glu, Gln Lys
• Succinyl CoA…….Phe, Trp, Tyr
• Fumerate………….Pro *****If there is a deficiency in Phe then Tyr becomes
• Oxaloacetate………Asp, Asn essential (like in PKU). If there is a deficiency in Met then
Cys becomes essential*****
Amino Acid Deficiencies
• PKU – Phenylalanine hydroxylase deficiency, needed to Restriction Enzymes
make tyrosine, leads to a lack of Dopamine, Epi and (Cut to the right unless otherwise specified)
Norepi, melanin, blonde/blue/fair, musty odor, Trypsin…………………………………………….Arg, Lys
phenylacetate & phenylpyruvate in urine (Guthrie test) Chymotrypsin…………………………….…..Phe, Tyr, Trp
• Maple Syrup Urine Disease –↓ degradation of branched Elastase…………………………………..……Gly, Ser, Ala
amino acids (Leu, Iso, Val), ↓ α-ketoacid Mercaptoethanol…………………………………...Met, Cys
dehydrogenase, defective transport in the kidneys Aminopeptidase…………………..………..amino terminus
• Cystinuria – Cystathione synthase deficiency; Cys, Carboxypeptidase…………….….Left of carboxyl terminus
Ornithine, Lys and Arg end up in urine (COLA), defect Cyanobromide......……………...……………………….Met
in renal tubular transport, cystine stones, Tx
Acetazolamide

6
2nd Messangers Co-factors for Pyruvate DH, α-ketogluterate DH &
cAMP……………Sympathetic, catabolic, CRH Branched Chain DH
cGMP………..…..Parasympathetic, anabolic (TLC For Nanna)(PLANF)(Vit. B 1-5)
IP3/DAG……..…..Smooth muscle contraction by horm./NT • TPP………………………….Thiamin (B1)
………All hypothalamic hormones (except CRH) • Lipoic Acid……………………………..B4
Ca:Calmodulin…..Smooth muscle contraction by distention • CoA………………..Pantothentic Acid (B5)
Ca++…………….Gastrin • FAD……………………….Riboflavin (B2)
Tyrosine Kinase…Insulin and all growth factors • NAD…………………………...Niacin (B3)
NO…………….…Nitrates, Viagra, ANP and LPS
Diseases with X-linked Inheritance
Autoimmune Antibodies Recessive
Disease Anti- • Burton’s Agammaglobulinemia
SLE • Smith • CGD (NADPH Oxidase deficiency)
• Double stranded • Duchenne’s Muscular Dystrophy
DNA • Color Blindness
• Cardiolipin • Hemophilia
Drug Induced SLE • Histone • G6PD
Progressive Systemic Sclerosis • Topoisomerase • Lesch-Nyhan
Graves • TSH Receptor • Pyruvate DH deficiency
CREST • Centromere • Fabry’s
Goodpasture’s • Glomerular Basement • Hunter’s
Membrane Dominant
• (aka. Type IV • Huntington’s
Collagen) • Vitamin D resistant Rickets
Primary Biliary Cirrhosis • Mitochondria
Alopecia Areata • Hair follicle Nephrotic Patterns of Vasculitis
Rheumatoid Arthritis • IgG Renal Artery Stenosis…………..Clot in front of renal artery
Multiple Sclerosis • Myelin Receptors Renal Failure…………………….Clot off entire renal artery
Celiac Sprue • Gliaden/gluten GN…………………………..…………..Inflamed glomeruli
Type I Diabetes • Islet cell receptor Papillary Necrosis…………………………....Clot in papilla
Interstitial Nephritis………………………...Clot of medulla
Vitiligo • Melanocyte
Focal Segmental GN…………….Clot off pieces of nephron
Myasthenia Gravis • Acetylcholine Rapidly Progressive GN…………..Clot off lots of nephrons
receptor
Mixed Connective Tissue • Ribonuclear protein MC Nephrotic Disease in Adults…………Membranous GN
Disease MC Renal Dis. in Blacks/Hispanics..…Focal Segmental GN
Pernicious anemia • Parietal cell receptor MC Renal Disease in HIV/drug users...Focal Segmental GN
• (aka. Intrinsic factor) MC Renal Mass…………………………………..……Cyst
Pemphigus vulgaris • Epidermal anchoring MC Malignant Renal tumor in adults……..adenocarcinoma
protein receptor MC Malignant Renal tumor in kids……….....Wilm’s tumor
• (aka. Intercellular
junctions of MCC of Rapidly Progressive GN……...…….Goodpasture’s
epidermal cells MC Nephrotic Disease in kids…....Minimal Change Disease
Bullous pemphigoid • Epidermal basement
membrane protein ***RPGN – crescent formations
Hashimoto’s • Thyroglobulin ***Minimal Change Disease – 2 weeks post URI
• Microsomal
Scleroderma • Smooth Muscle Thrombolytics and Rescues
• SCL-70 • tPa………………………………..Amioncaproic acid
Sjogren’s • Rho • Streptokinase…………………….Aminocaproic acid
• La • Warfarin………………………………..…Vitamin K
• SSA • Heparin…………………………….Protamine Sulfate
• SSB
If active hemorrhage give Fresh Frozen Plasma (FFP)
Wegener’s • Proteinase
• C-ANCA
Polyarteritis Nodosa • P-ANCA
Idiopathic Thrombocytic • Platelet
Purpura • (aka glycoprotein
IIb/IIIa)
7
Rashes Associated with Cancer
• Urticaria (hives)………..any, but especially lymphoma
• Paget’s Disease……………….....intraductal carcinoma
• Seborrheic keratosis……colon cancer (HIV is sudden ↑)
• Actinic keratosis……...squamous cell carcinoma of skin
• Dermatomyositis (heliotropic, malar)...……colon cancer
• Akanthosis nigricans....visceral CA & end organ damage
• Erythema nodosum………granulomatous (nonbacterial)
Lipoprotein Transport
• Chylomicrons: takes triglycerides from GI to liver &
endothelium
• VLDL: takes triglycerides from liver to adipose
• IDL: takes triglycerides from adipose to tissue
• LDL: only one to carry cholesterol
• VLDL: only made in the liver
• IDL + LDL: break down products of VLDL

Cancer Grading – Severity of microscopic changes Meningitis (MCC)

0 months - 2 months……Group B strep
Cancer Staging – Degree of dissemination of tumor ……E. coli
……Listeria
Tumor Markers/Oncogenes
2 months - 10 years……S. pneumoniae
l-myc Small cell carcinoma ……Neisseria meningitides
of the lung
c-myc Burkitt’s Lymphoma 10 years – 21 years……Neisseria meningitides
n-myc Neuroblastoma Over 21 years…………S. pneumoniae
c-abl CML, ALL
c-myb Colon, AML Indications for Pneumovax
c-sis Osteosarcoma, • Covers MC 23 strains
glioma, • Given at 2, 4 & 6 months
fibroscarcoma • Given to anyone over 65 years old
ret MEN II, MEN III • Anyone who is asplenic
k-ras Lung, Colon • Anyone with end organ damage (CF, RF, Nephrotic)
bcl-2 Follicular lymphoma
(can show up in HIV
Burkitt’s – pick Most Common Infection.…...…….……………….…..CMV
follicular first) Most Common Cause of death...……………..…………PCP
Rb Retinoblastoma p41.……………………………………just a surface marker
CEA Colon, Pancreas GP120…..……………………………….attachment to CD4
S-100 Melanoma Pol….……………………….………………….transcription
HER-II, Neu, Erb, Breast Reverse transcriptase….………...……………….integration
BRCA-I & II, p53, CSF-1 p17 and p24 antigens….…………..……………….assembly

Translocations Normal CD4 count: 800-1200 in adults (up to 1500 in kids)

9:22 Philadelphia Chromosome (CML) • <500: begin treating with 2 nucleotide
8:14 Burkitt’s Lymphoma inhibitors and 1 protease inhibitor (750 in kids)
14:18 Follicular Lymphoma • <200: is AIDS, add treatment for PCP
15:17 Promyeloblastic leukemia • <100: add treatment for MAC
11:14 Mantle Cell Lymphoma
11:22 Ewing’s Sarcoma Characteristics of Autosomal Dominant Inheritance
17:22 Neurofibromatosis • Affects males and females equally
• Manifests in heterozygous state
Enzymes Needed to Make Glycogen • Can be transmitted by either parent
• Glycogen synthase • Often delayed onset (adult dx)
• Branching enzymes • Vertical transmission
o glycogen α-1,4 glycosyl transferase • New mutations occur in germ cells of older fathers
o glycogen α-1,6 glycosyl transferase • Can exhibit reduced penetrance & variable expressivity
• Usually structural defects
Enzymes Needed to Break Down Glycogen
• Phosphorylase Characteristics of Autosomal Recessive Inheritance
• Debranching enzyme • Disease usually does not effect parents
• Α-1,6-Glucosidase • Disease may be seen in siblings and uncles
• Phosphatase • Often early onset (early dx)
• Disease only present when both alleles are mutant
• Horizontal transmission
• Usually enzyme defects (Inborn errors of metabolism)

8
Characteristics of Mitochondrial Inheritance Oxalate Stones
• All females will pass on the disease • In 3 y.o. white female – Cystic Fibrosis
• No males will pass on the disease • In 5 y.o. black female – Celiac Sprue
• All offspring of affected females will be affected • In Adult female – Whipple’s Disease
• Often affects CNS, heart and skeletal muscle • In Adult male or female – Crohn’s Disease
• Due to uneven cytokinesis during meiosis/oogenesis
Pituitary Hormones
Immune System Timeline Anterior: GH
< 24 hours → swelling Prolactin acidophilic
At 24 hours → neutrophils show up
Day 3 → neutrophils peak TSH
Day 4 → T-cells and MØ show up ACTH basophilic
Day 7 → Fibroblasts show up LH
1 month → Fibroblasts peak FSH
3-6 months → Fibroblasts are gone
Posterior: ADH (supraoptic nucleus)
Mitochondrial Diseases Oxytocin (paraventricular nucleus)
Leigh’s Disease: subacute necrotizing
encephalomyelopathy, progressive ↓IQ, seizures, ataxia,
cytochrome oxidase deficiency Sub-Acute Bacterial Endocarditis
Leber’s Disease: hereditary optic atrophy • MC bacteria is Strep. viridans
• Roth Spots
Tx for Hypercholesterolemia • Janeway lesions (toes)
Statins: P – Provostatin (only one renally excreted) • Osler’s nodes (fingers)
A – Atorvastatin • Splinter hemorrhages
L – Lovastatin liver enzymes every 3 months • Endocarditis
S – Simvastatin • Mycotic aneurysm (septic emboli)
MoA: Inhibit HMG CoA reductase Emphysema Types
• Most active around 8pm Bullous…………..Due to #1 = Staph. aureus
• Must take at night for max efficacy …………Due to #2 = Pseudomonas
Centroacinar……..Due to smoking
Atrial Action Potential Distal acinar ……..Due to normal aging
Phase 0 – depolarization Panacinar………..Due to α1-antitrypsin deficiency
Phase 1 – No name
Phase 2 – Plateau (A-V Node) Erythropoiesis
Phase 3 – Repolarization 4 months gestation……….Yolk Sac
Phase 4 – Automaticity (S-A Node) 6 months gestation……….Spleen, Liver, Flat Bones
8 months gestation……….Long Bones
Pneumonia (MCC) 1 year of age……………..Long Bones
6 wks – 18 yrs: RSV (infants only)
Mycoplasma **If long bones become damaged the spleen can take over,
Chlamydia pneumonia resulting in splenomegaly**
Strep. pneumonia
Diphtheria
18 yrs – 40 yrs: Mycoplasma • It’s toxin ADP ribosylates EF-2
Chlamydia pneumonia • Stops cell synthesis
Strep. pneumonia
• Gram positive
• Acquired exotoxin from a virus via transduction
40 yrs – 65 yrs: Strep. pneumonia
• Causes heart block
H. influenza
Anaerobes • Never scrape the membrane b/c it is highly vascular so it
Viruses will bleed and it will also release toxin
Mycoplasma
Cystic Fibrosis
Elderly: Strep. pneumonia • Sweat Test: >60 – definitive positive
Viruses <20 – Normal
Anaerobes 30-60 – Heterozygous
H. influenza • 2nd messenger is IP3/DAG
Gram negative rods • Gene is on chromosome 7
• Pilocarpine can be used to treat
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Inclusion Bodies Chelators
Howell-Jolly…………….………………Sickle Cell • Methylene Blue – Methemaglobinemia
Heinz…………………….…………………G-6-PD • Sodium Thiosulfate – Cyanide
Zebra…………………….………..…Niemann Pick • CaEDTA – Lead (to test)
Donovan……………….…………….Leishmaniasis • Penicillamine – Lead (in plasma)
Mallory……………………………..…..Alcoholism • Dimeraprol – Lead (in bone marrow)
Negri………………………………….……..Rabies
Councilman………………………….Yellow Fever **Tx for cyanide poisoning:
Call-Exner…………………………Ovarian tumors • Amyl Nitrate
Lewy……………………………………Parkinsons
• Sodium thiosulfate
Pick…………………………………Pick’s Disease
• Methylene Blue
Barr Bodies…………………………………Female
• Transfusion
Aschoff………………………..….Rheumatic Fever
Cowdry Type A……………………………..Herpes
Auer Rods……………………………………..AML Renal Tubular Acidosis (acidosis & hypokalemia)
Type I – High urine pH
Globoid…………………………...Krabbe’s Disease
Acidosis
Russell………………………..….Multiple myeloma
Frequent UTI
Schiller-Duvall………………….…..Yolk Sac tumor
Stones
Basal Bodies………………………...Smooth Muscle
Babies die <1 year
Allergic Response
Type II – Low urine pH (2)
Primary – CONTACT
Hypokalemia
• Neutrophils work in the first 3 days
NO carbonic anhydrase
• Then B-cells produce IgM
o Shows up at 3 days Type III – Combo of Type I and II
o Peaks at 14 days
Normal urine pH
o Gone in 2 months
Hypokalemia
• IgG
o Show up at 2 weeks Type IV – Diabetics
o Peaks in 2 months Hyperkalemia
o Gone in 1 year NO aldosterone (Infarcted JG apparatus)
Secondary – MEMORY Hemolytic Properties of Streptococcus
• IgG shows up at day 3 with 5x the concentration α- partial hemolysis Green zone
o Highest affinity for antigen β- Complete hemolysis Clear zone
o Peaks in 5 years γ- No hemolysis Red zone
o Stays for 10 years
Transduction
Amyloidosis Bacteria becomes deadly when a virus injects its DNA
AL Portion Primary amyloidosis, Transformation
homologous with multiple myeloma In a hospital or nursing home the bacteria has become
Ig Light chain deadly by this mechanism

AA Unique N- Chronic active disease, Conjugation

terminal sequence Hodgkin’s disease, Only occurs if bacteria has PILI

Pre-albumin Single amino acid Hereditary neuropathy, Coumadin vs Heparin

/transthyretin substitution nephropathy and Extrinsic Intrinsic
cardiopathy Tissue Blood
PT PTT
AB Β2 microglobin Cerebral artery Factors 2,7,9,10 Factor 3
amyloid, Alzheimers, p.o. i.v.
Downs, 8-10 hrs delay immediate
AE Endocrine Aging C/I in preg. Ok in preg.
Inhib Vit K dependant factor DOC for DVT
AP Universally associated with all amyloids
(Keep the PeT out side – extrinsic)
(PeT is Cujo who bites – p.o.)

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RASHES

Erythrma marginatum • small red spots with bright red margins, sand papery, Rheumatic fever

Erythrma chronicum migrans • target lesion, bullseye, Lyme disease

Measles • morbiliform rash, preceded by cough and conjunctivitis

Roseola • fever for 2 days then rash pops up (rash only after fever is gone), HHV 6

Erythema nodosum • tender nodules and redness on the anterior aspect of the legs
• red macules, target lesions, allergy and viruses
o Mild – Most common cause is viral (2nd is drugs)
Erythema multiforme
o Moderate – Stevens Johnson Syndrome
o Severe – Toxic Epidermal Necrolysis
Seborrheic dermatitis • scaly skin with oily skin on the hairline

Seborrheic keratosis • stuck on wart appearance

Psoriasis • silvery white plaques on extensor surfaces, scaly skin, pitted nails
• red macules, papules, vesicles, pustules then scabs: different stages at the same
Varicella Zoster
time, HHV 3
• rash/blisters on anterior thigh, associated with diarrhea due to Celiac Sprue flare
Dermatitis herpetiformis
up
Typhoid fever • rose spots associated with “intestinal fire”, Salmonella Typhi

Dermatomyositis • heliotropic rash

Erysipelas • reddened area with raised borders, does not blanch

Tinea cruris • redness, itchy groin

Pityriasis rosea • herald patch: dry skin patched that follow skin lines, HHV 7

Tinea versicolor • hypo-pigmented macules on the upper back in a “V” pattern

Scabies • linear excoriation on belt line and finger webs

Fifth Disease • “Slapped Cheeks” AKA Erythema Infectiosum, Parvovirus B19

Hepatitis B
Incubation: 4-26 weeks (8 wk average)
Acute Disease: 4-12 weeks
Convalescence: 4-20 weeks
Recovery: years

Acute recent infection HBcAg+, HBsAg+, (HBcAb +/-)

Recent Immunization (within previous 2 weeks) HBsAg+ only
Immunization (more than 2 weeks previous) HBsAb+ only
Previous infection, now immune HBcAb+, HBsAb+, HBsAg-
Infectious HBeAg+
Non-infectious HBeAg-
Chronic carrier HBsAg+ for more than 6 months (HBsAb+/-)
Window period HBeAb+, HBcAb+, HBsAg-

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HLA Markers Diseases Pneumonic
2 Itchy Sheep (Mary and Sarah), Sleep in a
DR-2 Narcolepsy, Allergy, Goodpasture, MS Goodpasture
DR-3 Sjogren’s, SLE, Celiac Sprue, Chronic Active Hepatitis 3 S’s and Chronic Active Hepatitis
DR-3 & 4 IDDM Type I
DR-4 Rheumatoid Arthritis, Pemphigus vulgaris RAP
DR-5 Juvenille Rheumatoid Arthritis, Pernicious Anemia JRAP
DR-7 Steroid Induced Nephrotic Syndrome
DR-3 & B-8 Celiac Disease
A-3 Hemochromotosis
B-8 Myathenia Gravis
B-13 Psoriasis w/o arthritis
Psoriasis w/ arthritis, Ankylosing Spondylitis, IBD,
B-27 Reiter’s, Postgonococcal arthritis 2PAIR
BW-47 21-α-Hydroxylase deficiency (Vitamin D)

Immunoglobulins

• Monomer in the blood

IgA • Dimmer in secretions
• Protects the mucosal surfaces and body secretions
IgD • Only known function is as a surface marker on mature B-cells
• Mediator of Type I hypersensitivity (anaphylaxis)
• Parasite defense
IgE • Responsible for allergies
• Fc portion binds to mast cells and basophils
• Does not fix complement
• Second to be produced during the primary immune response
• Only one to be produced during the secondary immune response
• In memory (secondary) response
o Shows up a 3 days with 5x the concentration of primary response
o Peaks around 5 years
IgG o Some remain in circulation for 10 years
• Has 4 subclasses (antigenic differences in heavy chains and with disulfide bonds)
o IgG1 – crosses the placenta due to Fc portion
o IgG2 – most common deficiency, susceptible to encapsulated organisms
o IgG3 – Most memory antibodies
o IgG4 – Only one that does not fix complement
• Present only in the primary immune response
IgM • Most effective in agglutination and complement fixation
• Defense against bacteria and viruses

Hyperlipidemias

Type Deficiency Component ↑ Misc Information

I Lipoprotein Lipase – defect of the liver type only Chylomicrons
II Receptor or receptor enzyme – IIa, IIb, or B100 LDL Most common in general population
III APO E receptor IDL
IV Lipoprotein Lipase – defect of the adipose type only VLDL
V Enzyme and receptor defect – APO CII Chylomicrons & VLDL Associated with diabetes mellitus

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Interleukins and Other Inflammatory Mediators
**IL = Interleukin** **IF = Interferon** **TNF = Tumor Necrosis Factor** **Transforming Growth Factor**
• Secreted by macrophages
IL-1 • Causes fever and other non-specific symptoms of illness
• Recruits Thelper cells
• Secreted by T cells
• Most potent
IL-2
• Most powerful Chemotactic factor (recruits everyone)
• Must be inactivated prior to transplantation
• Secreted by T cells
IL-3 • Causes B cell proliferation
• Labeled by Thymidine
• Secreted by T cells
IL-4 • Causes B cell differentiation
• Responsible for class switching to IgG and IgE
• Secreted by T cells
IL-5
• Responsible for class switching to IgA
IL-8 • Neutrophil Chemotactic factor
• Suppresses cell mediated response
IL-10
• Tells macrophages and T-cells to stay away if there is a bacterial infection
• Promotes cell mediated response
• If infection in non-bacterial it is released to recruit macrophages and T cells
IL-12 • Activates NK cells to secrete IF-γ
• Inhibits IL-4 induced IgE secretions
• Changes TH cells into TH1 cells
• Secreted by Leukocytes
• Inhibits viral replication and tumor growth
IF-α • Increases NK activity
• Increases MHC (class I and II) expression
• Interferes with protein synthesis
• Secreted by fibroblast
• Inhibits viral replication and tumor growth
IF-β • Increases NK activity
• Increases MHC (class I and II) expression
• Interferes with protein synthesis
• Secreted by T-cells and NK cells
• Increases NK activity
• Increases MHC (class I and II) activity
IF-γ
• Increases macrophage activity
• Co-stimulates B-cell growth and differentiation
• Decreases IgE secretion
• aka Cachectin
• Secreted by monocytes and macrophages
• Induces IL-1
TNF-α • Increases adhesion molecules and MHC class I on endothelial cells
• Is a pyogen
• Induces secretion IF-γ
• Cytotoxic/Cytostatic
• aka Lymphotoxin
TNF-β • Secreted by T-cells
• Cytotoxic
• Secreted by solid tumors (carcinoma<sarcoma) and monocytes
TGF-α
• Induces angiogenesis, keratinocyte proliferation, bone resporption and tumor growth
• Secreted by platelets, placenta, kidney, bone, T-cells and B-cells
• Induces fibroblast proliferation, collagen synthesis and fibronectin synthesis
TGF-β
• Inhibits NK, Lymphokine Activated Killer Cells, Cytotoxic T Lymphocytes, T cell & B cell proliferation
• Enhances wound healing and angiogenesis
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EKG Breakdown

Portion of EKG Portion of Heart Phase of Action Potential

P-wave Atrium 0
P-R interval AV node 2
Q-wave Septum 2
R-upstroke Anterior wall 2
S-downstroke Posterior wall 2
S-T interval Ventricle 2
T-wave Ventricle 3
U-wave Ventricle 4

Adhesion Molecules

IgCAM ICAM-1, ICAL-2, • Homing of lymph nodes to site of inflammation

ICAM-3 • Found on T-cells, endothelial cells, dendritic cells

LFA-3 • Mediate T-cell interactions

BINDING PROTEINS
• Found on lymphocytes, APC

LFA-2 (CD2) • Found on T-cells, NK cells

Integrins VLA-1 (β1) • Migration thru extracellular matrix

• Widely distributed

LFA-1 (β2) • Tight binding to endothelium

• Found on lymphocytes

CR3 (β2) • Tight binding to epithelium

STOPS THE LEUKOCYTES
• Phagocytosis
• Mac-1
• CD11/CD18

CR4 (β2) • Phagocytosis

• Opsonin receptor

Selectins E-selectins • Leukocyte migration and homing

• Found on activated endothelium

L-selectins • Initial binding to endothelium BIND CARBOHYDRATES

• Found on leukocytes MEDIATES “ROLLING”
(slows leukocytes)
P-selectins • Leukocyte migration to inflammatory sites
• Found on activated endothelium and platelets

Hypersensitivities
(ACID)
Type I - Anaphylaxis
• IgE binds to mast cells – degranulates mast cells
• IgA activates IP3 cascade – degrades mast cells
Type II - Cytotoxic (humoral) – Goodpasture, Autoimmune hemolytic anemia
Type III - Immune Complex mediated – Rheumatoid arthritis, SLE
Type IV - Delayed (cell mediated) – TB skin test, contact dermatitis, transplant rejection

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Mechanisms of Action

Drug Mechanism
5FU Inhibits thymidylate
Methotrexate Inhibits dihydrofolate reductase
Hydroxyurea Inhibits ribonucleotide reductase
Vincristine/Vinblastin Inhibit microtubule formation
Paclitaxel Inhibits microtubules from migrating
Levamisole Stimulates Natural Killer (NK) cells
1. Kills T-cell and Eosinophils
2. Inhibits macrophage migration
Steroids 3. Inhibits phospholipase A
4. Inhibits mast cell degranulation
5. Stabilizes endothelium
Statins Inhibit HMG CoA reductase
Niacin Decreases VLDL production in the liver
1st generation - Block potassium channels in the islet cells preventing insulin release
Sulfonylureas
2nd generation – Promote insulin release and inhibit gluconeogenesis in the liver
Miglitol/Ascarbose Inhibit glucose absorption from the GI
Metformin Stops gluconeogenesis in the liver
Troglitazone Increases the sensitivity of insulin receptors
Anti-psychotics Block dopamine receptors
Aspirin Irreversible inhibitor of cyclo-oxygenase
+
K Sparing Diuretics Competitive aldosterone receptor antagonist
Topical Anesthetics Block Na+ channels
Quinalones Block topoisomerase (supercoils)
Aminoglycosides Blocks Initiation Factor (IF) 2 on the 30S subunit
Tetracyclines Blocks tRNA binding on the 30S subunit
Rifampin Blocks beta subunit of RNA polymerase
Sulfa Drugs Blocks Para-Amino Benzoic Acid (PABA)
Cephalosporins Inhibit the cell wall
Penicillins Block transpeptidase
Chloramphenicol Blocks peptidyl transferase on the 50s subunit
Clindamycin/Lincomycin Blocks translocase on the 50s subunit
Macrolides Blocks translocase on the 50s subunit
Mitronidazole Increases production of free radicals
Vancomycin Blocks cell wall (phopholipid)
Benzodiazepine Increase the frequency of the GABA receptors via Cl- channels
Barbiturates Increase the duration of the GABA channels via Cl- channels
TCAs Block reuptake of catacholamines, AV conduction and alpha receptors
SSRIs Block reuptake of Serotonin
MAOIs Inhibit MAO
Lithium MOA is unknown but is suspected to be related to it mimicking of Na+
Valproic Acid Blocks Na+ and sometimes Ca2+
Carbamizapine Blocks Na+ and Ca2+
Epinephrine Blocks Beta (2>1) receptors and then Alpha receptors
1st generation – blocks H1 and H2 receptors (H1>H2)
Antihistimines
2nd generation – blocks H2 only
Decongestants Alpha agonists

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Antibiotic Coverage

Simple
Gram+ & All Gram- &
Gram+ Gram- Atypicals1 Anaerobes Rickettsia Other
S.aureus pseudomonas
only3
Quinolones X X X
Aminoglysides X
Tetracyclines X X X X
Cephalosporins X X X2

Penicillins X X2
Macrolides X X X
Sulfa Drugs X X
Chloramphenicol X X X
Clindamycin X X X
Vancomycin X X *
Metronidazole X **
Rifampin ***

1
Includes chlamydia, Mycoplasma, ureaplasma and legionella)
2
Simple only (no “Big Mama”)
3
H.Flu (not B) and E. coli)
* pseudomembranous colitis, MRSA and enterococcus
** protozoa
*** TB

PASS Program Clues (PP Clues)

Edited and Revised 3-3-08 by Fernando M. Chaves M.D.

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