cvs 15 Flashcards
FSGN is most common in
africans
hispanics
what type of sclerosis is seen in FSGN
and what cn be seen on microscopy
segmental
effacement of foot processes
causes of FSGN
HIV
interferron
Sickle cell
condyloma accuminatum
most common organ affected in amyloidosis
AL AA —–> kidney
stain for amyloidosis
congo red
green birefringence under polarized light
diabetes most common primary organ affect
EYE — microaneurysm
then kidney
two mechanisms of damage in diabetes
non enzymatic glycosylation —- diabater glomerulopathy
osmotic damage
thickening of blood vessels primaryl effcets which vessel
efferent
inc GFR
inc FF
inc PR
what type of sclerosis seen in diabetes
eosinophilic nodular glomerulosclerosis
kimmelsteil wilson nodules
mixed cryoglobulinemia most commonly assoc with
hep C
mannifestation of cryoglobulinemia
joint —- arthralgia
skin — purpura
IC depostion of IgG and igA
osler weber rendu
AD
dialation of vessles / mucosa —- RESP GI SKIN
recurrent epistaxis / melena/ hematuria
primary biliary choalngitis
chronic autoimmune disease characterized by infiltration of lymphocytes
intraheptatic bile ducts …. medium and small sized are destroyed
which disease has same mannifestations as Graft vs HOST
PBC
pbc most common in ?
antibody?
middle aged females antimitochondiral antobody (igM)
antimicrosomal igG antobody seen in
hashimoto throiditis
treatment of ursodiol
dissolving gall stones
because in PBC there is stasis of bile (cholestasis)
solubilization of cholestrol
primary sclerosing cholangitis
assoc with UC
p ANCA
igM and in MALES
beaded appearance string of peal seen in
PSC
intrahepatic bileducts undergo fibrosis and strictures
PSC can progress to
secondary biliary cholangitis
cholangiocarcinoma of bile ducts
porcelain gall bladder seen in
adenocarcinoma of g bladder due to chronic cholecystitis
granulomatous thyroiditis
de quervain —-PAINFUL
viral infection
pathological fractures in teenagers
what is the most common cause
OSTEOSARCOMA
malignant condition
benign eosinophilic granulomas + pathological fractures in teenagers
langheran cell histiocytosis
RESTRICTIVE LUNG DISEASE
WHIP GLANDS Wegners granulomatosis Hypersensitivty pneumonitis Idiopathic pulmonary fibrosis Pneumoconiosis Good pasture Langheran cell histiocytosis ARDS NRDS Drugs (5fu) Sarcoidosis
origin of langheran cells
mesodermal
CD1a and s100 +
langheran cells
special dendritic cells of skin
langheran histiocytosis mannifestations
lytic bone lesions — increased calcium
skin rash
recurrent otitis media
Dystrophic calcification occurs in
abnormal diseased tissue
tends to be localized
assoc condition of dystrophic calcification
fat necrosis liquefactive necrosis aortic stenosis TB (lung pericardium) rubella CMV toxoplasmosis PSAMMOMA
PSAMMOMA bodies seen in
Papillary carcinoma thyroid / ovaries Somatostatinoma A Meningioma Mesothelioma Ovarian serous cystadeno carcinoma Milk (prolactinoma) A
Metastatic calcification
in normal tissues
widespread (diffused)
INCREASED calcium levels
conditions assoc with metastatic calcification
hyperparathyroidism
increased vitamin D ( inc absp of ca and po4-)
sarcoidosis
milk alkali synd
calciphylaxis — calcium accumulates in small vessels of skin or fat — clot/ulcers
multiple myeloma — bone break down disease
adult t cell lymphoma —- HTLV1
which group is HTLV1 from
retrovirus
RNA
how does sarcoidosis increase calcium
non caseating granuloma makes 1 alpha hydroxylase
this convers 25 HCC from liver into 125 DHCC (kidney)
active form of vit D
what happens to calcium levels in alkalosis
negative cahrge increases ( as the H+ ions decrease)
calcium binds to the negative COO- ….. HYPOCALCEMIA —- tetany
peripancreatic fat
saponification
NOTCH 1 gene
familial biscuspid AV
most common cause of subacute endo
str viridians
mutans and sanguins
adhere to fibrin and platelet aggregates prev damaged valves with DEXTRANS — insoluble polysaccharides (sucros)
subacute endo can be assoc with
MVP
vegetations deposited
insidious (gradual onset)
biofilm is produced by
strept viridians
strept epidermidis —- prosthetic valve , catheter
pseudomonas
biofilm helps as a barrier to
antibiotic penetration (opsonization)
Tcell activation is also prevented by biofilms
pseudomonas can be assoc with
ventilator supp/ resp epithelium —- cystic fibrosis
contact lens —– keratitis
strept viridians optochin
reistant
staph epidermis
NO senstive
urease +
normal flora skin
staph epidermis can effect
prosthetic valves hi join (biofilm)
acute bacterial endocarditis caused by
staph aureus
NORMAL valves
normal flora nasal cavity / axilla / ears
staph aureus
normal flora skin
s epidermis
normal floa oropharynx
viridians
normal flora vagina
lactobacillus / e.coli
normal flora of colon
b. fragilis
painful skin fever rash increased AST ALT shock
TSST -1
acute suppurative parotitis is most commonly seen in
elderly post operative intubated use of anticholinergic drugs --> decrease secretions obstruction ---> silolithiasis
test for acute supp parotitis
imaging
serum AMYLASE
normal pancreatic lipase
exfoliative toxin from staph
blistering lesion
(desmoglein)
(protease)
enterotoxin from staph
food poisoning (2-6 hrs)
preformed toxin
non blood diarrhea
mcc of skin soft tissue abcess normal vs nocosomial
staph a
pseudomonas
Mec A gene
low affinity for B lactams
txt for MRSA
vancomycin TMP SMX clindamycin doxycycline linezolid ceftaroline (5th gen) daptomycin
use of daptomycin in MRSA resp infections
NO
surfactant inhibits daptomycin
aortic endocarditis can lead to which types of fistula
intra cardiac
aorto cavitary
culture negative endocarditis on native valves
Hemophilus Actinobacillus Cardiobacterium/ coxella Eikenella Kingella
iv drug abusers endocarditis
pseudomonas
staph aureus
causes of osteomyelitis in DIABETICS vs SICKLE CELL
diabetics —— pseudomonas
sickle cell —– salmonella
adenocarcinoma right side vs left side
right side bleeds
left obstructs
causes of non bacterial endocarditis
hypercoagulable state (virchows) — P.embolism
malignancy ( mucin activates coagulation)
SLE —- vegetations on both sides of valve
FROMJANE
Fever Roth spots Osler nodes (painful, immune complex) Murmur (M R ) Janeway lesions (painless) erythematous Anemia of chronic disease (micorcytic) Nail bed hemorrhage Embolization
causes of mitral valve prolapse
marfan / ehler danlos COXSACKIE B ---- rupture of c tendenai post MI ---- mitral valve rheumatic fever ADPKD
VSD murmur
holosystolic TRICUSPID area
large vsd vs small vsd
large — low intensity
small — high intensity
VSD can be assoc with
Down synd fetal alcohol synd cri du chat babies of DIABETIC MOTHERS Edward (18) patau (13)
most common congenital defect in babies of diabetic mothers
TGA
due to failure of aorticopulomary septum to spiral
Tricuspid regurgitation causes
endocarditis IV drug abusers (staph a )
rheumatic fever
carcinoid (TI PS )
