Systemic Flashcards
What happens with acute inflammation
- vasodilation 2. structural changes 3. PMNs
What happens with chronic inflammation
Macrophages, lymphocytes, plasma cells, Tissue destruction, repair.
Granulomatous inflammation
Marked by a large amount of macrophages.
What affects wound healing
decrease blood flow, other infections,
What happens with cell death?
Lack of oxygen and increased anerobic respiration results in increase cellular Na. If this prolongs necrosis will occur.
Necrosis
The death or one or more cells as a result of irreversible damage.
Coagulative necrosis
Occurs with heart attack. The structure is maintained but inside is sad
Liquefactive necrosis
Lungs with fungus.
Caseous Necrosis
TB.
Hypersensitive Reactions
ACID
Type I hypersensitivity
analphyactic. IgE mediates and bind to mast cell for degranulation. Ca binds the next time for increased response. Initial is 5-30 and late 4-6 hours.
Type 2 hypersensitivity
Cell mediated. Occurs with IgG and IgM. Attacks a foreign body but also hurts the own cell.
Type 3 hypersentivity
Immune complex mediated. Antigen/AB complexes. Occurs with lupus. No foreign part.
Type 4 hypersentivity
Delayed. T lymphocytes encounter an antigen and release luekokini leading to macrophage activation.
Systemic Lupis Erythromatosis
SLE. W>M. 30s. Mallar rash. Type 3. Can have dry eye, disc edema, papilledema, etc. ANA+
Rheumatoid Arthritis
W>Ms. 50’s. Synovial shift in morning so pain is worse. Dry eye=aqeuous deficient. ANA and RF+
Scleromalacia perforans
common with RA. Necrotizing scleritis without inflammation.
JIA
W>M. chronic bilateral non-granulomatous anterior uvieits. Can have a low grade fever. ANA+
Sjogren’s Syndrome
Dry mouth, eye, and arthritis. No arthritis in primary.
Sarcoidosis
Middle aged african American women. non-caveating granulomous and increased ACE. Order a lung X-ray if suspect.
SE with Sarcoidosis (The big 6)
- Anterior granulomatous uveitis 2. bells palsy 3. vitritis (cotton balls) 4. vasculitis (candle wax) 5. ON disease 6. Dacroadentitis
Ankylosing spondylitis
M>F. Young. Has a bamboo spin, sacroiliitis, uveitis, and aortic regurgitation. HLAB27 and X ray should be ordered.
Reactive arthritis
M>F. Urethra, uveitis, joint pain. HLA B27.
Psoriatic Arthritis
Sores in synovial fluid so join pain. HLA B27
Which disease are HLA B27 postiive
CRAP. Chrns, reactive arthritis, Ankylosing, psoriatic.
Which are ANA positive
RA, SLE, JIA,
Giant Cell arteritis
AAION. Superior temporal can affect SPCAs. Have scalp and jaw tenderness. Test to order include ESR, CRP, CBC/WBC, and temporal artery biopsy. Has skip lesions.
Granulomatosis with polyangiitis
(weaner’s granulomatosis). Vasculitis including the kidney, lungs, and upper respiratory tract. Can cause granulomatous sclerouveitis.
Scleroderma
tightening of the skin. Can cause dry eye and shrinkage of areas of the skin and conj.
Gout
Uric acid in the MTP (podogra). Painful. Men.
Band keratopathy
Calcium in bowman’s
Congenital immunodeficinty disease
IgA. Born with less. Can have keratinization of cornea, weight loss, diarrhea, and reccurnt upper respiratory tract infections.
AIDS
Caused by HIV an RNA virus that does reverse transcriptase to make DNA.
What CD4 count means you have aids
200 or less
Tests to run for Aids
ELISA and Western blot
Most common infection with AIDs
Cytomegalovirus retinitis, pneumonia, toxo, TB, kaposiosacroma.
Seborrheic Keratosis
Benign. Elevated stuck on appearance.
Keratocanthoma
Isolated dome shaped nodules. Remission over months.
Papillomas
Viral slow growing epithelial tumors that may be caused by HPV. Look like skin tags. HPV can cause cervical cancer.
Xanthelasma
Yellow plaque lesions in lid. Associated with high cholesterol.
Molluscum contagiosum
Common in kids. Spread by DNA pox virus. Dome shaped waxy nodules. If multiple think HIV.
Acne Rosacea
telengectasia and rhinopehyma. Can have hordeolum, chalzia, phlyctenulues, keratitis, and dry eye.
Allergic contact dermatitis
Type 4.
Impetigo
Grame + infection. Honey colored crusted lesion. Very common in kids.
HSV 1
Above the belt. More likely ocular
HSV 2
STD. Can have ocular manifestations with birth. Herpetic keratitis in neonates. Dendritic keratitis can also occur.
Herpes zoster virus
Chicken pox and shingels. Will have keratitis with pseudo dendrite.
Behcet’s disease
Middle east. Must have 2 of the following (skin lesions, mouth lesions, genital lesions, ocular lesions). Have acute recurrent hypopyon.
Superficial spreading melanoma
The most common variant of melanoma. It has rapid growth and is found on non-exposed skin
Basal cell carcinom
Most common. Telengectasia. Can have a rodent ulcer
Squamous cell carcinoma.
No telengectasia. More likely to metastasize. Arises for actinic keratosis.
Sturge Weber syndrome
Capillary malformation. Can cause glaucoma due to increase episcleral venous pressure. Can also cause iris heterochromia. Have port wine stain.
Tuberous sclerosis
Astrocytic hamartomas. Grows tumors in the brain and other organs. Have hypo pigmented macule, shagreen patches, angiofibromas, and brown plaque on the forehead.
Down syndrome
Trisomy 21. Prominent epicanthal folds, congenital cataracts, strabismus, glaucoma, keratoconus.
Klonefelter’s syndrome
XXY.
Turner’s syndrome
XO. Keratinous. BV issues (CI, strabismus, amblyopia, reduced accommodation)
Von hippie Lindau Disease
AD. Benign and malignant tumors. Retinal angiomas can rupture.
Neurofibromatosis Type 1
AD. Von recklinghauson’s disease. Tangle of tissue. Optic nerve glioma, litchi nodules, cafe au last spots.
Marfan’s syndrome
AD. Connective tissue disorder. Long stature. Keratinous. Sublimation of lens up. Aortic problems. Floppy valves.
Huntington’s chorea
AD. Bad movement and eye movemens
Familial adenomatous polyposis
AD. Gardner’s is a variant that will have CHRPE lesions (4 or more). Refer for testing as 100% with FAP will get colon cancer.
Sickle Cell
AR. glutamic acid on beta goblin to valine. Sickling of cell. African american. Sea fan retinopathy. Can get jaundice. Decrease hemoglobin, MCV normal, increased reticulocyte.
Tay Sach’s
AR. Cherry red spot. Atrophy of ON with increased glycolipids.
The only AR conditions we talked about
Sickle cell, Tay sach’s, PKU.
The only AD conditions we talked about
Huntingtons, Von hippie, Neurofibromatosis, FAP, Marfans.
The only X linked conditions we talked about
Fabry’s and Duchenne musclular dystrophy.
Leber’s Hereditäre Optic Neuropathy
Mitochondrial. Cause central vision loss. My mother leber lost my eyes.
What tests to order for anemia
CBC-Hgb and MCV
Anemias with MCV low
All low HGB. Low MCV with iron deficient anemia and aplastic anemia.
Iron deficiency anemia
Most common. Pica.
Aplastic Anemia
Attack all cells in the bone marrow (pancytopenia). Acetazolamdie and chloramphenicol can cause
Issues with normal MCV
Sickle cell and chronic kidney disease (cannot release as much erythropotein)
Anemias with increased MCV
Folate acid anemia, and Vitamin B12 deficiency.
Vitamin B12 Deficiency
Cobalamin. Often caused by pernicious anemia.
Folic acid deficiency
Occurs in pregnancy and alcoholism. Worry about neural tube defects with pregnancy.
Multiple Myeloma
Cancer of plasma cells. Affects kidney. Increased Ca in blood.
Hodgkins lymphoma
40% lymphoma. Reed-sterner cells. Associated with EBV.
Non-hodgkin’s lymhoma
60%.
Acute Lymphoblastic leukemia
Better prognosis. Increase lymphoblasts
Acute Myeoblastic Leukemia.
Poor prognosis. Increased myeblasts. Auer rods in blood cells.
Chronic Lymphocytic Luekemia
Better prognosis.
Chronic Myeocytic Leukemia
Worse prognosis. Associated with philidelphia chromosome.
Leukopenia
Decreased number of WBC
Lukocytosis
Increase in the abolsute number of WBC