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immunology Flashcards

1
Q

HIV early appearence

A

flue like prodrome

fever night sweats and weight loss

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2
Q

aids + CD4

A

CD4 <200 cells and or the presence of an opportunistic infection

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3
Q

AIDS labs

A

Elisa for initial screening is >99% sensitive

Western blot is confirmatory

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4
Q

AIDS absolute CD4 lymphocyte count

A

normal is >800

CD4 lymphocyte percentage to AIDS is high when <20%

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5
Q

AIDS viral load

A

should be zero, results correlate with progression of HIV

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6
Q

HIV PJC pneumonia propholaxysis

A

pneumocystis (pneumonia) jirovecii -leading cause of death in AIDS patinetns
Bactrium propholactally

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7
Q

Antiretrovetrial therapy

A

HAART
start at the time of HIV diagnosis
but not later than CD4 of 350

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8
Q

osteoarthritis

A

degenerative joint diseasease
weight bearing joints
swelling but NOT redness or heat
h

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9
Q

OA heberdines

A

distal interphalangeal joints DIPS where you hold the herb

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10
Q

OA Bouchards

A

Prohimal interphalangeal joints PIPS

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11
Q

OA pain

A

better in the morning gets worse over the day

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12
Q

OA x-ray findings

A

narrowng of the joint space
osteophytes
juxta articular sclerosis
subchondral bone

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13
Q

OA meds

A

ASA
Tylenol
Nsaids
Celebrex cox-2 inhibitor

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14
Q

OA supportive care

A 
weight loss
cane on opposite side
ICE to improve ROM
moist heat to decrease spasm and relieve stiffness
PT
refer for joint replacement
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15
Q

RA def

A

systemic autoimmune disease causing inflammation of the connective tissue

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16
Q

RA inflammation is

A

symetrical

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17
Q

RA age

A

35-50 yonger than OA

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18
Q

RA gender

A

women more than men 3-1

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19
Q

RA pain

A

worse in morning better as day goes on

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20
Q

RA labs

A

ESR usually elevated, ANA in 1/5 patients

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21
Q

RA diagnostics

A

synovial aspirate with inflammatory changes and WBC’s

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22
Q

RA x-ray

A

Joint swelling - OA is narrowing, cortical thinnin, osteopenia,

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23
Q

RA drugs

A 
high dose salicylates
nsaids
DMARDS
corticosteroids
methotrexate
antimalarials
gold salts injections
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24
Q

RA management

A

early rheum referral
rest
PT
surgery

25
Orthor term avulsion
bone fragments pulled off by attached ligaments or tendons
26
dislocation vs subluxation
disloction is disruption of normal relationship of bones, subluxation is incomplete discloction, dislocation is confirmed by x-ray
27
methotrexate lab
watch LFTs
28
Open fracture treatment
IV abx, sterile dressing, tetanus prophylazis and surgical debredment.
29
Compartment syndrome
in the closed facial compartment, sever pain, skin profusion and arterial pulses are NORMAL, passive streth of the muscle is painful, repeated limb measurements are necessary
30
lupus affects primarily
primarily wome of childbearing age butterfly rash- affects 50% of paitntes but will be on test ana will be +
31
lupus management
bedrest naps avoid fatigue sun protection
32
drugs that make you look like lupus
``` INH methaldopa qunidine thorazine hydralzine procanimide ```
33
giant cell arteritis
temperoal arteritis inflammtory condition primarily affeting patients ove the age of 50, can lead to permanaet blindenss. 50% of all cases fo fever of unknown origin over age 65
34
giant cell arteritis
``` fever 103-104 scalp pain rigors and chills nodular enlarded or tender high esr and normal WBC temproal artery biopsy is positive in 85% ```
35
giant cell areritis tx
referral and prednisone taper
36
sinusitis most pronounced feature
post nasal drip
37
optic disk
doughnut with orange/pink neurorential rim, and a central white depression
38
cup disk ratio
cup should be no more than 1/2 the side of the disc diameter (if bigger consider glaucoma)
39
eye arteries are brighter red and NARROWER than veins ratio is
2-3 or 4-5 A-V
40
macula centered
2-2.5 disc dimeters temporal to the optic disc and is avascular
41
Fovea centralis looks slightly darker and lies
in the center of the macular region, if macula is hard to see have the patient look directly into the light.
42
common eye problems diabetic retinopathy
diabetic retinopathy- microanurysms are the earliest detectable sign, either superficial (flame shaped) or deeper (blot and dot) cotton wool spots
43
eye problem asociated with chronic hypertension
AV nicking-
44
arcus senilis
cloudy appearence of the cornea iwth a gray white arc or circle around the limbus due to deposition of the lipid material, has no effect on vision
45
conjunctivitis
msot common eye disorder, inflammation/infection of the conjunctiva (pink eye) resulting from alergies, bacteria, virusis or std sti NO PAIN
46
Conjunctivitis S and S Bacterial
``` purulent discharge- self limiting, abx drops: levofloxacin ofloxin ciprofloxacin tobramycin gentamycin eye drops ```
47
gonococcal or chlamydial conjunctivitis
``` copious purulent drainage gonoccal ceftriaxone, 250 mg IM chlamydia erythromycin ointment oral tetracycline, clarimycin, or doxy ```
48
allergic conjunctivitis
stringy, increased tearing, oral antihistamines
49
viral conjunctivitis
water dranage symptomatic
50
corneal abriasion def
trauma to the epithelia surfac of the eye INTENSE PAIN
51
corneal abrasion tx
sodium fluroesen stan detects abrasion topical abx or sulfonamide drops pressure patch for 24 hours steroid drops are contraindicated and pain drops after exam cauuse u want to eval progress should be heald in 24 hours if not refer.
52
glaucoma
increased IOP open angle is chronic CLOSED ANGLE is emergence 10-20mmhg is normal
53
glaucoma chronic
cupping of optic disc | constriction of visual fields
54
glaucoma acute
``` closed angle extreme pain blurred vision halos around the lights pupil fixed or dialated ```
55
glaucoma test
tonometry- national screening by age 40
56
management - glaucoma open
alpha 2 agonist- brimonidine, alhagan, beta adrenergic blocker- timolol
57
management glaucoma closed
emergency diamox- carbonic anyhydrase inhibitors mannitol surgery
58
cataract def
cluding and opacificatoin of the normally clear lense of the eye highest cause of treatable blindness most common surgical procedure in 65+, senile cataracts
59
cataract S and S
``` painless clouded or blurred vision, sensitivity to light iwth ellowing of colors DOUBLE VISION IN A SINGLE EYE no red light reflex opacity of the lense ``` refer to opto for sx

issues and policy (22 decks)

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