16 Flashcards
disseminated Histoplasmosis
HSM (with calcifications) and tongue lesions (often)
Lung nodules similar to TB
complement fixation, immunodiffusion
serological tests to measure Abs
young (otherwise healthy)
fatigue, progressive dyspnea, atypical chest pain, unexplained syncope.
leads to hypertrophy and/or dilation of right ventricle (cor pulmonale)
Look for thickened RV
PAH
Birth defect study: women who had a baby with a birth defect are more likely to remember exposures than mothers who had a normal baby
Recall Bias
Peyronie disease
excess collagen formation within tunica albuginea = pain and hook dick
JAK2 Inhibitor approved for tx of primary myelofibrosis
Ruxolitinib
Drugs that cause hypersensitivity myocarditis
diuretics (furosemide, HCTZ) and antibiotics (ampicillin, azithromycin)
Alcohol fixed neutrophils…
think ANCA
CD16 and CD56+
Do not require thymus for maturation and are present in athymic patients
Activated by INF-gamma and IL-12
NK cells
SMA and IMA anastomosis
marginal artery (of Drummond)> mesenteric meandering artery (arc of Riolan)
Vinyl chloride, arsenic or thorotrast exposure
hepatic angiosarcoma
Results from failure of vitelline (or omphalomesenteric duct) to obliterate. Toddlers may have GI bleeding due to ectopic gastric mucosa
meckel diverticulum
Well tolerated antirheumatic drug used in RA and SLE. ADR= irreversible retinopathy. Patients must have regular eye exams!
Hydroxychloroquine
Tetracycline antibiotic with weak antirheumatic activity. ADR: photosensitivity
Minocycline
Medical therapy Conn’s Syndrome
Aldosterone antagonist such as spironolactone or eplerenone
SAH vasospasm
Autoregulation impairred. Do a Transcranial color doppler to see
Most feared comp. of SAH
rebleed
Proteasomes
degrade nuclear and cytoplasmic proteins
Lysosomes
degrade cellular organelles and Extracellular proteins
RNA interference (base pairing with complementary strands)
Posttranscriptional gene siliencing
Translation repressed (imperfect)
mRNA cleavage (perfect)
miRNA (mutations can cause cancers) and Si RNA (c-MYC therapy)
Normal epithelium to early adenoma
APC mutation
Early Adenoma–>Late (increase in size)
K-Ras Mutation (proto-onco) - uncontrolled cell proliferation
Malignant transformation of adenoma in carcinoma
mutation of two genes required: DCC and p53 (anti-oncogene mutation)
BRCA (anti-oncogene)
supresses cell cycle
WT-1 (tumor suppressor/anti-onco)
Wilms tumor
N-myc oncogene
Increased number of copies of gene (amplification) Neuroblastoma
Colon cancer (diet that leads too)
high in cholesterol and carbs
low in fiber
Protects fatty acids from oxidation
Vit. E
Corneal softening
keratomalacia
Abdominal pain diarrhea and nausea = acute
Chronic= calcium oxalate kidney stones
Vit. C overuse
Acetylation (slow) of INH can have have toxic effects —reduce dose
also actylate
Dapson, Hydralazine and procainamide
Azathiprine and 6-MP biotransformation
methylation (fast and slow)
Note:
Patients who take opioids on the reg…develop tolerance to respiratory depression very quickly
Tolerance also developed to itching and N/V and i guess drowsiness
When is aortic regurg heard best?
After closure of aortic valve (A2) along the left sternal boarder at the third and fourth intercostal spaces while the patient is sitting up and leaning forward with the breath held in end expiration
Left shift in oxy-Hb curve
Lower P50 (partial pressure of O2 in blood at which Hb is 50% saturated)...Higher affinity saturates to 50% quicker thus lower P50 think left shift = lower P50
Very severe anemia, strenous workout would shift
curve to right
DRESS SYNDROME DRUGS: fever, GAD, facial edema and diffuse morbilliform skin rash–> confluent erythema with follicular accentuation
Labs: eosinophillia, atypical lymphocytes and elevated ALT
phenytoin and carbamazepine
allopurinol
Sulfonamides (sulfasalazine)
Minocycline and vancomycin
Essential for GBM diagnosis
Necrosis
Common is prominent microvascular proliferation
Neuritic process called a neuropil
Pathognomonic for neuroblastoma
MYCN (N-MYC)
Chromosome 2 neuroblastoma
NSE, chromogranin, synaptophysin and S-100 positive
Elevated VMA and/or HVA
Pulsion
pathogenesis of false diverticula (increased pressure)
ex: in colon (strained bowel movements due to chronic constipation
