Block 40 Flashcards
Non fusion of urethral folds
- In females is normal —> vestibule vagina formation
- In males it leads hypospadias. (Epispadias on the contrary is due to abnormal opening of the urethra on the dorsal surface of the penile shaft that results from faulty positioning of the genial tubercle in the fifth week of gestation.
Poison ivy dermatitis
- its a form contact dermatitis.
- poison ivy,poison oak and poison sumac all produce urushiol, a small allergenic substances that causes an immune response when attached to proteins ( ie. heptan).
- following contact these plants, patients develop highly pruritic, erythmatous rash consisting of papules, vesicles, and bullae that may show signs of excoriation.
- the rash most frequently affected exposed skin and often forms linear streaks as the patients walks past the the plant, dragging it along the skin.
- contact dermatitis is a type IV hypersensitivity(delayed-type) reaction.
- CD8+ T cells are the primary effector cell and directly destroy keratinocytes expressing haptenated proteins.
- it occurs in 2 phases , senseitization phase and elication phase
Sickle cell anemia mutation
Glutamic acid (negative) —
Coal worker pneumoconiosis
- form of interstitial lung fibrosis secondary to long term inhalation of coal particles.
- inorganic dust is constantly being inhaled and must be cleared by the respiratory tract to prevent disease.
- the clearance mechanism used by the lung vary depending on the size of the particles. Larger particles become trapped by mucus secretion in the trachea, bronchi and proximal bronchioles, these trapped particles are swept upward toward the pharynx by the collective beating of cilated cells.
- the finest particles (eg coal) reach the repsiratory alveoli and bronchioles where they are phagocytozed by alveolar macrophages.
- engulfment of inorganic dust causes MAC activation and release of number of cytokines that induce pulmonary inflammation.
- GF,IGF and PDFG also released —> fibroblast proliferation and collagen production —> progressive interstitial lung fibrosis.
MCL injury
- the MCL attaches proximal to the medial epicondyle of the femur and resists forces that push the knee medially. MCL injury typically occurs after twisting njury or blow to the lateral knee while the foot is planted (valgus stress injury).
- valgus stress test is performed with the knee extended by placing one hand along the lateral thigh and pressing inward while the other hand is placed on the medial aspect of the ankle and pushed outward.
- laxity of the knee and/or medial joint line widening indicates MCL injury.
Clear cell carcinoma -RCC
- gross painless hematuria
- the patients biopsy will show round/polygonal cells with abundant clear cytoplasm which is characteristic for Clear cell carcinoma
- clear cell carcinoma originates from PCT epithelial cells and contains copious amounts of intracellular glycogen and lipids.
Cystic degeneration of the putamen most commonly associated with
Willson disease
Caudate nucleus is affected in
Huntingtons disease
Hypertrophic obstructive cardiomyopathy is mutation in
Autosomal dominant disease of the cardiac myocytes caused by mutation of several sarcomere encoding gene encoding the myocardial contractile proteins.
-common mutation include single point mutations in the gene for beta-myosin heavy chain and myosin binding protein C.
Vitamen E deficiency is present with what neruological deficits
- Degeneration of posterior column
- Degeneration of spinocerbellar tracts.
(Friedrich ataxia like symptoms)
What is the most important prognostic factor in tetrology of fallot
- RV outflow tract (RVOT). The amount of RVOT obstruction that determines how much deoxygenated blood cross the VSD to the aorta and to sytemic circulation —> more cyanosis
- infants with no or minimal RVOT obstruction,deliver more deoxygenated blood to the lungs and appear a-cyanotic.
- the obstruction degree is dynamic and certain changes such as dehydration or hyperventilation can lead to profound cyanosis “tet spells”)
AML stain
Myeloblasts have large number of rod shaped intracytoplasmic granules called auer rods that stain for peroxidase.
Dermatomyositis
-systemic autoimmune disease charactrized by proximal muscle weakness resembling plymyositis, but with additional inflammtory features involving the skin.
-skin findings include the heliotrope rash in the peri-orbital areas and cheeks along with gottron’s papules, which are raised erythmatous plaques over the joints and bony prominences of the hands.
-muscle biopsy is diagnostic and shows mononuclear perimysial infiltrates, perifascicular atrophy, and patchy necrosis.
-it may occur as a consequence of paraneoplastic syndrome of underlying malignancy. The most commonly associated cancers include ovarian, lung ,colorectal and nonhodgkin.
-
Clindamycin in alcoholics
- clindamycin: pulmonary infections in alcoholics commonly include anaerobic oral flora admixed with aerobic bacteria. Necrotizing infections and lung abscesses may result.
- if abscess is present, the best agent to be given is clindamycin as it covers against most anaerobes and also covers gram positive organism aerobes such as s.pneumoniae.
- it works primarily by attaching to the 50S ribosomal subunit in bacteria
- clindamycin usually is given for above the diaphragm anaerobic infections while metranidazole is given to below diaphragm infections.
Ethosuxemide mechaism
Blocks thalamic T-type Ca+ channels
