block 20 Flashcards
post streptococcal GN
clinical deatures :
if symptomatic
- gross hematuria
- edema (periorbital, generalized)
- hypertension
LAB:
- urinalysis+protein +blood +/- RBC casts
- decreased C3 and possible decrease in C4
- increased serum creatinine,anti DNase B and increase AHase
- increased ASO & increased NAD
L/S ratio
lecithin is a component of pulmonary surfactant and sphignomyelin is common membrane phospholipid. its common test to asses lung maturity in utero.
-commonly lecithin is elevated in the thrid trimister and sphingomylin levels begins to decrease
psaos abscess
it can occur due to direct spread of infection from an adjacent structure or from hematogenous or lymphatic seeding from a distant and possible unknown site.
- risk factors include D.M , IV drug use, HIV infection and other forms of immunusupression.
- signs and symptoms include fever, back or flank pain, inguinal mass, and difficulty walking.
- pain is excacerbated by movement that causes psaos muscle to be streched or extended, such as extension of the hip (psaos sign).
decreased perfusion of peripheral tissue induces ?
number of neuroendocrine compensetory mechanisms, such as:
- Renin-angiotensin-aldosterone mechanism: decreased renal perfusion leads to diminshed strech of glomelular afferent arterioles and increased synthesis of renin. increasd AG II –> increase arterial resistance and afterload
- increased sympathetic output is stimulated by baroreceptors that sense decreased perfusion, epinephrine and NE increases HR and contractility. but these neurotransmitters also increase peropheral arterial resistance therby increasing afterload.
PCR is used to
amplify small fragments of DNA by repeated replication.
-several elements are required for PCR.
the first is a source DNA template, as well as flanking sequences adjacent to the target region.
-a thermostable DNA polymerase is then used to replicate DNA template from a pool of supplied deoxybucleotide triphosphate using 3 steps (denaturing, annealing and elongation)
structre of MHC I vs MHC II
MHC1=
- heavy chain and beta 2 microglobulin.
- all nucleated cells
- presents antigen to CD8+ cytotoxic T-cells
- types of antigens: viruses, tumor proteins, antigens are processed in the cytoplasm.
- Antigen presentation results in apoptosis of the presenting cells
MHCII=
- alpha and beta polypeptide chains
- found exclusively in APC
- present antigen to CD4+ T-helper lymphocytes
- bacterial, antigen are phagocytosed and digested by lysosomes within which Ags binds to MHC II
- activation of TH cells, which stimulates the humoral and cell mediated immune response
treponoma pallidum diagnosis
spiral shaped gram negative spirochete.
- classically dark-field microscopy of material scraped from the surface of the cutaneous syphlitic lesion is the fastest and most direct method for diagnosis.
- most commonly the diagnosis is confirmed indirectly with serologic testing :
1. nontreponopmal test (VDRL), rapdi plasma ragin (RPR) evaluate for the presence of antibody against cardiolipin.
2. treponomal tests: (fluorescent treponomal antibody absorption FTA-ABS, detects antibodies specific treponomal antigens and are not affected by antitreponemal therapy.
45,x ,46,xx turner is which type of mutation
-somatic mosaicism
differnce between germline mosaicsim and somatic
- somatic: affects the cells forming the body, causing disease manifestations to develop on affected individuals. e.g 45,x,46xx
- germline: affects cells that give rise to gametes, allowing the affected genes to pass to the offspring. but the affected parent doesnt develop clinical manifestations.
HPV affect on the respiratory system
- it can cause papilloma in the true vocal cord (not the flase)
- HPV have a predilection for stratified squamous epithelium, which is found in the anal canal, vagina, and cervix. in the resperatory epithelium the true vocal cord are the only ones that are covered with stratified squamous epithelium.
infants HPV
-infants can acquire respiratory papillomatosis via a passage through the birth canal of mothers infected with the virus, warty growth on the true vocal cords can lead to weak cry, hoarsness and stridor.
peripheral neuropathy in DM
the most importnat mechanism for development of diabetc neuropathy :
- non-enzymatic glycosylation of protein leads to increased thickness, hylainization and narrowing of the walls of the arteries. –> diabetic microangiopathy of endoneural arterioles, ischemic nerve damage follows.
2/. intracellular hyperglycemia occurs in peripheral nerves. accumulating glucose is converted into sorbitol and fructose by aldose reductase, –> sorbitol increases cell osmolarity and facilitates water influx into the cell.–> damage to axons and schwann cells.
types of diabeic neuropathy:(3)
1. distal symmetric polyneuropathy : sensory (paresthesias, intense burning pain, loss of pain/tempreture/ vibration/ position sensation.
motor: weakness, atrophy and decreased DTR. (both are symmetric and bilateral invloving feet and hands in a stocking and glove distribution.
2. autonomic polyneuropathy: GI: gastroparesis, consipation.
cardiovascular: orthostatic hypotension
urinary: overflow incontinence, neurogenic bladder.
sexual: erectule, and ejaculatory abnormalities.
3. mononeuropathy : cranial : CN III, CN VII, and optic.
somatic : median ulnar and common fibular nerves
valproic acid teratogenic effect
- spina bifida, meningiomyocele and more
- neural tube defects.
common teratogens
- phenytoin : neuroal tube defects,orofacial clefts, microcephaly, nail or digit hypoplasia
- lithium: ebstein anomaly, nephrogenic DI,
- isoteretonin: microcephaly, thmic dysplasia, small ears and hydrocephalus
- methotrexate: limb and craniofacial abnormalities, neural tube defects and abortion.
5.ACEi: RENAL DYSGNESIS, OLIGOHYDROAMNIOS
6.Warfarin: nasal hypoplasia, and stippled epiphysis.
clearance of a given substance (equation)
(e.g substance S )Cs= ([urine concentration of S] X [urine flow rate]) / (plasma concentration of S)
for creatinine this can result in estimation of GFR and for PAH this can result in estimation of RPF
-normal filtration fraction for normal individual equals 20%
