Extra Path from Meeran Questions Flashcards
what are Cabot rings?
looped structures in RBC
seen in megaloblastic anaemia
gene mutation in TTP
ADAM-ST13
what is the mutation in Glanzmann thrombasthenia?
mutation of GLP-2a/3b
what is the problem in Bernard Soilier syndrome?
mutation in GLP-1b
what is Hairy cell leukaemia? what marker?
subtype of CLL
tartare resistant acid phosphotase
mantle cell leukaemia translocation
11;14
DLCBL translocation
14;18
CMML translocation
5;12
what is 5q syndrome?
deletion of long arm on Chr 5
hypo-lobulated megakaryocytes, increase platelet count
what should a splenectomy patient get as prophylaxis?
Pen V
pneuomoccoal/ Hib/ meningiococcal
what are the features of sickle cell trait on blood film?
no abnormal features
what is the percentage of HbA2 in B-thalamassaemia minor?
> 3.5-4.1 %
cold AIHA causes
cold LID
Lymphoproliferative: CLL, lymphoma
Infections: myoplasma, BBV
treatment of cold AIHA
chlorambucil
what Abs are seen in Paroxysmal Cold Haemogloburia?
Donath-Landsteriner Abs
3 features of PNH
PNH pneumonic
Pancytopaenia
New thrombus
Haemolytic anaemia
what is the transferrin level in IDA and why?
transferrin is high
compensates for low Fe
best Abs to measure in pernicious anaemia
anti-parietal cells
what condition is chondrocalcinosis seen in?
haemochromatosis
what is the ALP in MM
normal
what is an important prognostic factor in MM?
beta-2 microglobulin
features of nodular HL
non-classical
lymphocytic and histologic cells = popcorn cells
features of nodular sclerosing HL?
nodular pattern with fibrous bands
what is 5q syndrome?
subtype of myelodysplastic syndrome
what is Trastuzumab?
a.k.a. herpcidin
Her +ve breast cancer
what special cells can be seen in myocarditis in Rheumatic fever?
Aschkoff bodies
Anitschow cells
features of cells in small CC lung cancer?
Oat cells
what does the e4 allele of apolipoprotein E increase the risk of?
Alzheimer’s
features of pemphigoid
IgG binds to hemidesmosomes
Nikolsky sign -ve
pemphigus antibodies
IgG to desmosomes = acantholysis
what are the signs in Psoriasis?
Auspitz sign
Munro Abscesses
Test tubes in a rack
what histopathology in scleroderma?
onion skin thickening
what is the HNPCC mutation?
mismatch repair gene
histo features of a teratoma
contains all 3 embryonic germ cell layers
torsion common
when do you get basophillic stippling?
beta-thalassaemia
lead poisoning
when do you see acanthocytes?
hyposplenism
histo feature of squamous cell carcinoma in lung?
intracellular prickles
what is a comminuted fracture?
bones splintered
intact soft tissue
what is a transverse fracture?
right angle to bone long axis
may be partial or complete
compound fracture
penetrates skin
what causes an eosinophiluria?
tubulointerstitial nephritis
features of giardia lambia
pear shaped trophozite
foul smelling, non bloody sterrohoea
stool contains cysts
features of C. jejuni
oxidase positive, non-motile bacteria
features of shigella
non-motile
non-hydrogen sulphide producers
what test for leptospirosis?
agglutination test
serovars D-K
genital chlamydia
serovars L1, L2, L3
lymphogranuloma venereum
pupil in syphillis
Argyll-Robertson
symptoms of Haemophillius Ducreyi and agar
chancroid
painful genital ulcer than leads to painful swollen lymph nodes
chocolate agar
what causes donovanosis?
Klebsiella granulomatis
= donovan bodies
Pityrasis versicolor appearance under wood lamp
spaghetti with meatballs
what does sporothix schemchi cause?
rose prick ulcer
infection to bone
medium for brucellosis
castaneda medium
skin condition in Lyme disease
erythema migrans
Rocky Mountain Fever bug
Rickettsia species
Rocky Mountain Fever symptoms
thrombocytopaenia
hyponatraemia
elevated liver enzymes
histological feature of Psittacosis?
cytoplasmic inclusions
key histo feature of Rabies
cerebral Negri bodies
what agar and appearance of Staph Aureus?
golden colonies on blood agar
Yersinia enterocolitica
enterocolitis
gram -ve rod
what are the oxidase positive organisms
PuNCH Me Very Lightly Pseudomonas Neisseria Campylobacter Helicobacter Moraxella Vibro Legionella
cause of cutaneous leishmoniasis
L. major
what is the marker of Hep B infectivity?
HBeAg
only found in blood when replicating
what does Human African trypanosomiasis cause? what vector?
sleeping sickness
Teste fly
different forms of this bug and onset
Gambiense = gradual infection Rhodeiense = rapid infection
what does trypansoma cruzi cause?
Chagas disease
symptoms of Chagas disease?
purple rash on eyelid
dilation and dysfunction in heart, colon, oesophagus
length of fever in P. malariae
quartan fever
mauver’s cleft
falciparum malariae
Schuffner’s dots
P. vivax
P. ovali
biochemical abnormality in Conns
hypernatraemia
hypokalaemia
what urine osmolality suggests a renal cause?
> 20
What biochemical abnormality in Addisons?
hyponatraemia, hypokalameia
symptoms of Bartter syndrome
hypokalaemia
alkalosis
hypotension
difference between T1, T2, T3 RTA
T1: distal tubule
T2: proximal
T3: both
liver enzyme results in NAFLD
inc AST, ALT, GGT
AST: ALT <1
bilirubin and albumin normal
what is pseudohypoparathyroidism?
resistance to PTH
high PTH and P but low Ca
signs of homocystinuria
fair skin
brittle hair
developmental delay
signs of PKU
fair hair
developmental delay
eczema and seiures
Maple syrup urine disease signs
organic aciduria
sweet odour
sweaty feet
what is Fabry’s disease?
lysosomal storage disease
alpha-galactosidase
developmental delay
Cherry red spot
urea cycle symptoms
encephalopathy and neuro symptoms
symptoms of peroxismal disorder
seizures
dysmorphic features
severe muscle hypotonia
phenytoin toxicity symptoms
hypotension
heart block
arrhythmias
ataxia
digoxin OD
tiredness abdo pain confusion PR interval prolonged bradycardia
Theophylline OD
nausea diarrhoea tachycardia headaches seizures
Procainamide toxicity
rash
fever
agranulocytosis
how does carbamezepine cause hyponatraemia?
stimulates vasopressin
what are the SIADH criteria?
2 in blood 2 in urine, 3 exclusion
- 2 in blood: low Na, hypo-osmolality
- 2 high in urine: high urinary Na, high urinary osmolality
- 3 exclusions: no renal/adrenal/cardiac disease, no hypovolaemia, no contributing drugs
pseusohypoparathyroidism syndrome?
physical signs
Albright’s osetodystrophy
physical signs: short height, short 4th/5th metacarpals, decreased IQ, endocrinopathies
(mum mutation)
pseudopseudohypoparathyroidism?
similar physical features to pseudo
but no biochemical abnormality of Ca
(dad mutation)
results of water deprivation test in craniogenic DI, nephrogenic DI
Craniogenic: dilute urine (<300) but concentrated after desmopressin (>800)
Nephrogenic: dilute urine before and after desmopressin
Koebner’s phenomian
appearance of psoriasis plaques at site of injury
normal osmolar gap
<10 mmol/L
what would cause a high osmolar gap?
think additional solutes
e.g. ethanol, methanol, acetone
features of tyrosinaemia
Quebec FTT bloody stool lethargy jaundice cabbage like odor
what is the ALP in myeloma and why?
direct osteoclast activation by cytokines
no osteoblasts = no raised ALP
what is the mutation in CVID?
MHC III
what is Felty’s syndrome?
RA and splenomegaly
what does cANCA go against?
proteinase 3
proteins that antibodies are against in MS
myelin basic protein
proteolipid protein
what is the autoantibody in AIHA?
Ab against Rh antigen
what is the T cell target in RA?
synovial membrane antigens
how does cyclophosphamide work?
alkylates DNA
prevents replication
affects B cells more than T
what is Abatcept?
CTLA-Ig fusion protein
treatment of RA
what does mycophenolate mofetil do?
impaired guanine synthesis
what does Basilixumab tatget?
against IL-2alpha (CD25)
what is the target of Efalizumab
antibody against CD11 alpha on T cells
inhibits migration
treatment of psoriasis
what is the pathology of Lupus nephritis?
deposition of IgG, IgM, IgA, C3 in sub endothelial segment of glomerular BM
what does the AIRE in thymus do?
presents T cells with range of organ specific antigen
what is the cause of autosomal recessive SCID?
ADA deficiency
Ab in Pemphigus
Abs against demoglein 1 and 3 (cadherins)
Ab in pemphigoid
Ab to hemidesmosomes
what is a T3SR?
targeting antigens not fixed to cell surface
immunology of EEA
immune complex of Ab and inhaled antigen
deposition in walls of alveoli
process of a T4SR
- macrophages present antigen
- CD4 recognise peptide and bind
- causes macrophages to release IL-12
= production of memory CD4+ T cells of Th1
what do memory T cells release? leads to what?
IFN-gamma, IL2, IL3
these activate macrophages that then produce TNF-alpha
what is an autograft?
transplant of tissues tp same patient
e.g. CABG
what does gp41 do?
stabilised attachement
what does the gag protein do?
provides infrastructural support for HIV
what is adalimumab?
fully human monoclonal Ab to TNF-alpha
nucleolar pattern
anti-RNA polymerase
= underlying systemic sclerosis
cytokine in systemic sclerosis
TNF-beta
what is anti-IA2?
antibody to tyrosine phosphatase in T1DM
what is the type of hepatits in AI hepatitis?
interface hepatitis