ccleeee finals Flashcards
_________ also known as ________ is a
fungal infection that affects the nails, most commonly
the toenails.
Tinea unguium, onychomycosis,
The most frequent cause of onychomycosis is (TrTmEf)
Trichophyton Rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum.
It frequently causes infections in human sin, nails, and hair.
Trichophyton rubrum
This organism feeds on keratin, a protein found in the outer layer of these tissues, and is linked to conditions such as athlete’s foot, jock itch, ringworm, and fungal nail infections.
Trichophyton rubrum
Morphological features of Tr (WPCTM)
○ White to cream-colored colonies
○ Powdery texture
○ Cherry-red reverse
○ Teardrop or peg-shaped microconidia
○ Macroconidia, if produced by some isolates, are narrowly club-shaped, thin, and smooth-walled with 3-8 septa
Excessive thickening of the skin under the nail and separation of the bed from its nail
Hyperkeratosis and Onycholysis
This indicates a secondary bacterial
infection or localized inflammation,
likely due to the chronic irritation
caused by the fungal infection.
Mild erythema and swelling around the affected nails
causes poor venous return, leading to fluid accumulation in the limb.
deep vein thrombosis (DVT)
Diabetes mellitus contributes significantly to the severity of mechanisms:
- Weakened Immune System
- Poor Circulation
- Neuropathy
- Elevated Blood Sugar Levels
- Microangiopathy and Hypoxia
Inflammatory nail disease causing rough, brittle, or shiny pitted nails, often linked to alopecia areata and psoriasis.
Trachyonychia
Nail detachment from the bed
due to trauma, infection, or psoriasis.
Onycholysis
______ causes a linear border, while ______ create jagged edges.
Trauma, fungal infections
Complete nail shedding from temporary matrix arrest, triggered by infections, trauma, or chemotherapy.
Onychomadesis
Nail grows into the skin, causing pain and infection, often due to trauma, poor footwear, or improper trimming.
Onychocryptosis (Ingrown Nail)
Common nail cancer mimicking
fungal infections, linked to sun exposure, HPV, and trauma, presenting with tumors, onycholysis, and ulceration.
Nail SCC
Aggressive cancer appearing as a thick, dark band with nail fold pigmentation (Hutchinson’s sign),
Nail Melanoma
Identifies fungal hyphae in
nail scrapings.
KOH Preparation
Determines the specific fungal species.
Fungal Culture
Confirms fungal invasion in nail tissue.
Histopathology with PAS Stain
Provides highly sensitive and specific identification of fungal species
PCR or Molecular Testing
The first line treatment and it is an allylamine antifungal agent that is the most effective against dermatophytes.
TERBINAFINE
is a newer triazole medication with a broad antifungal spectrum that includes dermatophytes.
ITRACONAZOLE
is active against common
dermatophytes, Candida species and some nondermatophytic molds.
FLUCONAZOLE
topical triazole antifungal solution used to treat mild to moderate toenail onychomycosis (fungal infection of the toenails)
EFINACONAZOLE
is a type of blood thinner that helps prevent blood clots from forming or growing larger.
Warfarin (Vitamin K antagonist)
A group of blood thinner that helps to prevent blood clots from forming or growing larger without the need for INR monitoring.
Direct Oral Anticoagulants (Apixaban, Rivaroxaban, Dabigatran, Edoxaban)
refers to the rapid, clonal proliferation in the bone marrow of lymphoid or myeloid progenitor cells known as lymphoblasts and myeloblasts, respectively.
Acute Leukemia
The proliferation of leukemic blasts in the bone marrow disrupts normal hematopoiesis, leading to decreased production of RBCs.
Bone Marrow Infiltration
The overcrowding of the bone marrow by malignant cells suppresses the development of erythroid precursors, resulting in anemia.
Suppression of Erythropoiesis
This test counts the number of cells and identifies types of cells in the blood
COMPLETE BLOOD COUNT
Observe the structure of blood cells under a microscope to identify any unusual or immature white blood cells (blasts), which are indicative of leukemia.
PERIPHERAL BLOOD SMEAR
Assesses blood clotting ability.
COAGULATION TESTING
Analyze the bone marrow, the source of leukemia, to evaluate the proportion of abnormal blood cells (blasts), helping to confirm the diagnosis and identify the specific type of leukemia.
BONE MARROW ASPIRATION AND BIOPSY
It determines the origin of ALL
FLOW CYTOMETRY
is a medical examination of a body after death to find the cause and sometimes manner of death
autopsy
was performed by a hospital pathologist in cases of natural death to find and better understand the cause of death
Clinical Autopsy
This type of autopsy is necessary when a death is unnatural, suspicious, unknown, violent, related to industrial hazards, and associated with medical or surgical treatment in which there’s alleged medical negligence.
Forensic Autopsy
is a systemic examination of biological specimens obtained during the postmortem process in order to detect, identify, and quantify various chemical substances such as drugs, poisons, and toxins that may have contributed to death
Toxicological analysis
Originate from the external environment; introduced into the body through ingestion, inhalation, dermal absorption, or injection
Exogenous toxins
Produced internally, often as part of normal metabolic processes or as by-products of pathological conditions, and may accumulate to toxic levels under certain circumstances
Endogenous toxins
Widely employed for its precision in separating and identifying volatile compounds, ensuring a reliable detection of drugs and poisons in postmortem samples.
Gas Chromatography-Mass Spectrometry (GC-MS)
An advanced spectroscopic technique, that complements the other methods, by providing rapid screening and confirmation of the chemical composition of contraband substances.
Fourier-transform infrared spectroscopy
An emerging approach that has demonstrated high sensitivity and speed in detecting narcotic drugs like Tramadol in both seized samples and biological fluids, thereby enhancing routine forensic examinations
Gas Chromatography Infrared Spectroscopy
Has also revolutionized the field by enabling direct analysis of glucuronidated metabolites without the need for extensive sample pre treatment, thus reducing the risk of false negatives that may occur during enzymatic hydrolysis
Liquid Chromatography-Tandem Mass Spectrometry
is a highly potent synthetic opioid that is widely used in the clinical setting for analgesia, anesthesia, and sedation due to its rapid onset of action and high lipid solubility, yet its toxicity presents significant challenges in both medical and illicit contexts.
Fentanyl
