Day 4.3 Micro Flashcards
Know how to label brain stem/nerves p411
.
What does the pineal gland do?
secretes melatonin (lack of light –> SCN –> pineal –>melatonin) to regulate circadian rhythm
Superior and inferior colliculi
Superior - conjugate vertical gaze center
Inferior - hearing
eyes above ears
Parinaud syndrome
paralysis of conjugate vertical gaze d/t lesion in superior colliculi (e.g. pinealoma)
Pituitary adenoma effect on vision
Can compress optic chiasm and cause bitemporal hemianopsia (loss of vision in half of each eye, on the outside of each eye (can still see through inner half of each)
What kind of cells have horseshoe pattern of nuclei?
Giant cells
e.g. Langerhans giant cell of Mycobacterium TB
What are “red snappers” histologically?
Mycobacterium TB organisms stain red with acid-fast staining.
Ghon focus vs Ghon complex
Ghon focus - calcified scar (usu lower lobes)
Ghon complex - focus + hilar lymphadenopathy or calcification.
These are both from primary TB. They are NOT caseating. Caseating stuff is secondary TB (reactivation, reinfection)
Mycobacterium kansasii esp affects which pts
Causes pulmonary TB-like sympt, esp in chronic bronchitis or emphysema pts (COPD pts)
Dx’g TB
Culture on Lowenstein-Jensen agar, but takes 2-4 wks bc v slow-growing.
In the meantime, take early morning sputum 3 days in a row and acid-fast stain it.
Mycobacterium scrolfaceum
Causes cervical lymphadenitis in kids
Mycobacterium marinum
Aquatic-assocd- in boaters, shipyard workers, aquarium owners
Usu superficial skin lesion, but can cause osteomyelitis, arthritis.
Why do pts with leprosy injure their hands and feet?
Mycobacterium leprae (Hansen’s dz) infects the superficial nerves- so pt loses sensation. Loss of sensation means injury is common (w/o realizing it)
Which kind of leprosy is communicable (contagious)?
Leprotamous. Presents diffusely over skin.
vs Tuberculoid, which is limited to nodules
What pts get toxicity to dapsone (leprosy drug)
Causes hemolysis esp in G6PD-deficient pts, bc they are sensitive to oxidizing drugs.
Can use rifampin + clofazimine + dapsone instead.
Dapsone is used to treat…
Leprosy (M. leprae)
PCP pneumonia
Water contaminated w animal urine
Leptospira
Hanta virus - assoc w rat/mouse urine
What is a unique feature of leptospira px?
Jaundice.
Otherwise causes flulike sympt like everything else. Not many infections cause jaundice.
What is azotemia?
Increased BUN and increased creatinine, indicating kidney dysfn. Seen in Weil’s dz (ictohemorrhagic leptospirosis)
What is tree-barking of the aorta?
Aortitis- severe inflammation/disfigurement of the aorta, due to destruction of vaso vasorum (sml arteries supplying aorta)
seen in tertiary (3) syphilis
Diseases w rash on palms and soles
Secondary(2) syphilis
Rocky Mtn Spotted Fever
Cocksackie A virus
Stg 2 Lyme dz sympt
Neurologic- Bell’s palsy (can be bilateral or unilateral). Meningitis, peripheral neuropathy, ridiculopathy (referred pain).
Cardiac- AV nodal block, myopericarditis
What are keloids?
Scar w excess collagen
Seen in Yaws (Treponema pertenue)
Yaws
caused by Treponema pertenue
infection of skin, bone, joint –> healing w keloids –> severe limb deformities and facial deformities, esp destruction of nasal bones and cartilage.
VDRL+ (but not an STD)
Tabes dorsalis
Degeneration of dorsal columns and dorsal roots d/t (3)Tertiary syphilis. These carry sensation and esp proprioception.
Get broad-based ataxia- wide gait bc can’t tell where legs are
+romberg sign
What does “pupil constricts w accommodation” mean?
Take finger and bring it to nose- pupil will constrict as eyes watch finger. (Accommodation is watching something get closer)
Seen in argyll-robertson pupil (3 syphilis)
Romberg test
Stand w feet together, arms out, eyes closed.
To know where you are in space, you have 3 things:
1. vision
2. proprioception
3. vestibular apparatus
You need at least 2 of these to not fall down.
Romberg takes away vision, so if you are missing one of the other ones (either proprioception or your vestibular apparatus) you will fall.
Tabes dorsalis of syphilis - no proprioception bc dorsal columns have degenerated, so you fall.
(Arms out is just to know which direction pt will fall in)
Cause of Charcot’s joints
Previously: tertiary syphilis. now, don’t have so much tertiary, so the cause is diabetic neuropathy