QNA 3 Flashcards
Pathophys diverticulosis
- Low fibre diet -> chronic constipation -> increased pressure
- Connective tissue disorders
1 + 2 ->muscular hypertrophy
herniation of mucosa through wall
Why no diverticularis within small intestine
As neurovascular bundle enters the muscularis propria, points of weakness are created
These are re-enforced with a longitudinal layer of muscle in small intestine
In large intestine, these longitudinal muscles form 3 bands only (taeniae coli)
Could herniate through between these bands
Why endometriosis cause pain
intrapelvic bleed
Peri-uterine adhesions
Endometriosis cancer risk
3times risk of ovarian cancer
Types of graft rejection
Hyperacute: Immediate
Acute:
- Accelerated acute: within 7 days
- within 100 days
- treated with high-dose steroids
Chronic:
- T cell
- months-years
3 separate gene mutations for insulinoma
- MEN 1
- PTEN/TSC2 tumour suppressor genes
- ATRX and DAXX ->maintenance of telomere
MRSA decol
Mupirucin nasal cream
Chlorhexadine body wash
Causative agents for osteomyelitis
G +:
Staph aureus
Strep pneumonia
G -:
E coli
H influenza
Pathogenesis of osteomyelitis
- Inflammation
- microbial invasion -> inflammation ->increased interosseus pressure -> pain and obstruction of - Suppuration
- Pus appears in the medulla and spread along Volkmanns canal
- Lifts periosteum, spreads along the shaft, and forms subperiosteal abscess
- pus could re-enter at a different point - Necrosis
- raised pressure, vascular stasis, infective thrombosis comprises blood supply to bone, resulting in death and formation of SEQUESTREUM - New bone formation
- 10-14 d after
- deep layer of periosteum forms new bone becoming INVOLUCRUM (enclosing infected tissue and sequestra) - a : Resolution
- if infection is controlled, intraosseus pressure decreases and bone will heal
5.b. Chronic OM
- if not controlled, pus may break through the involucrum, and track by sinus to skin surface
MEN I
- pancreas insulinoma
- parathyroid hyperplasia
- pituitary adenoma
MEN II
Phaeochromo
Parathyroid hyperplasia
Thyroid medullary carcinoma
MEN IIb
MEN II + Marfinoid habitus + Mucosal neuroma
MEN 1 vs MEN2 mutation
Autosomal dominant
MEN 1:
- Menin gene
MEN 2:
- RET protoconcogene
Where is carcinoid tumour commonly found
Small intestine
Appendix
Origin cells of carcinoid
Enterochromaffin cells
Secretion of carcinoid
serotonin
Sx of carcinoid tumour
Flushing
Diarrhoea
Cadiac: valvular abnormality, fibrosis of endocardium
Wheeze (bronchial constriction)
Met site of carcinoid
Liver
Why carcinoid present after met to liver
Seretonin produced by bowel passes through liver and gets broken down before spreading
But when produced by liver, enters the systemic circulation
Dx of carcinoid
Chromagranin A blood
5HIAA 24hr urinary test
Haemorrhoids def
swollen anal cushions
Pathogenesis of haemorroids
Anal cushions fixed by fibromuscular ligaments
Repeated strained defecation -> downward stress tears the fibromuscular ligaments
Can become engorged with blood/prolapse
What is TNF
a cytokine in systemic inflammation
Anti TNF drugs
IgG antibodies against TNF
Infliximab
Adalimumab
Difference between proto-oncogene and oncogene
Proto-oncogene: normal genes promoting cellular proliferation
Oncogene: mutated or over expressed protooncogenes resulting in abnormal proliferation
