Wed jul 29 Flashcards
what is a cavernous hemangioma?
vascular malformation most commonly in the brain parenchyma - consists of dilated thin walled capillaries
presentation of a cavernous hemangioma?
may have seizures and neurologic symptoms due to mass effect. May also result in a bleed
where would the hemorhage from a cavernous hemangioma be?
intraCEREBRAL area
do the melanocytes in a junctional nevus go into the dermis?
no
presentation of junctional nevus?
flat, pigmented macule
do the melanocytes of a compound nevus extend into the dermis?
yes
presentatino of compound nevus?
raised papule, pigmented
presention of intradermal nevi?
raised, skin to tan coloured, dome shaped moles
where does the maxillary branch of CN V exits the skull?
infraorbital foramen
where does the opthalmic branch of CN V exits the skull?
supraorbital foramen
how is neurocysticercosis spread?
ingestion of eggs from stool of carriers (can be from eating pork)
where is HIV-2 found?
west africa
waht is the asymptomatic period of HIV2?
10-25 years
HIV2 is intrinsically resistance to which drugs?
NNRTIs and fusion inhibitors
what is modafinil?
stimulant used to treat narcolepsy
what happens to pyruvate under hypoxic conditions?
instead of being converted to acetylcoa for TCA cycle, it is converted to lactate by lactate dehydrogenase leading to lactic acidosis
what substances inhibits pyruvate dehydrogenase under hypoxic conditions?
NADH
phenylalanine is converetd into what, by phenylalanine hydroxylase?
tyrosine
what is the precursor substance to DOPA?
tyrosine
what will be seen grossly in the brain of someone with PKU?
hypopigmentation of catecholaminergic nuclei
I cell disease has a lack of what?
mannose-6-phosphate
The lack of mannose-6-phosphate in I cell disease results in what?
lysosomal enzymes secreted extracellularly instead of being delivered to lysosomes
pathophys of I cell disease?
lysosomal enzymes secreted extracellularly -> enzymes in blood can lead to tissue damage, and the substances that would have been broken down in lysosomes accumulate intracellularly
clinical manifestations of i cell disease?
claw hand deformity, joint stiffness, kyphoscoliosis, clouded cornea, coarse facies, gingival hyperplasia
enterobius vermicularis AKA
pinworm
enterobius vermicularis presentation
itchy anus at night time
where are eggs found in enterobius vermicularis ?
eggs are laid around anus
transmission of enterobius vermicularis ?
fecal oral route
who is typically affected by enterobius vermicularis ?
children
diagnosis of enterobius vermicularis ?
scotch tape test- will see eggs
treatment of enterobius vermicularis
pyrantal pamoate OR albendozale
ancyclostoma duodenale and necator americanus are what type of worms?
hookworms
where are ancyclostoma duodenale and necator americanus found?
southern USA
transmission of ancyclostoma duodenale and necator americanus?
penetrate skin, move to lungs, get coughed up and get into intestine
ancyclostoma duodenale and necator americanus may lead to what complication?
iron deficiency anemia
diagnosis of ancyclostoma duodenale and necator americanus?
eggs in stool, high eosinophil count
treatment of ancyclostoma duodenale and necator americanus?
pyrantel pamoate or albendazole and WEAR SHOES
transmission of ascaris lumbricoides?
eating eggs in contaminated food/water, then eggs hatch in intestine and largva crawl through wall into blood, go to lungs, swallowed and go back down into intestine and repeat
what type of worm is ascaris lumbricoides?
giant roundworm
presentation of ascaris lumbricoides?
asymptomatic, or may present with respiratory symptoms or malnutrition, or intestinal obstruction at ileocecal valve
diagnosis of ascaris lumbricoides?
eggs in feces and eosinophilia
treatment of ascaris lumbricoides?
albendazole
strongyloides stercoralis tranmission?
- penetrate skin and travel in blood to lungs, gets swallowed and mature in GI tract
- may autoinfect its host by laying eggs in intestine wall
diagnosis of strongyloides stercoralis
NO EGGS IN stool. Will find LARVAE in stool
what will be found in the stool of an infection with strongyloides stercoralis?
larvae
treatment of strongyloides stercoralis
ivermectan or albendazole
trichinella spiralis presentation?
fever, vomiting, periorbital edema, myalgia
transmission of trichinella spiralis?
undercooked meat such as pork or bear
what type of worm is trichinella spiralis?
nematode
trichinella spiralis leads to inflammation where?
striated muscle
dracula medinensis transmission?
water contanimated with copepods containing larvae
presenation of dracula medinensis?
adult female migrates to skin and forms painful skin ulcer
treatment of dracula medinensis?
slowly pull worm out
onchocerca volvulus transmission?
black fly bites host, and large go into skin and mature and the microfliaria migrate throughout body
presentation of onchocerca volvulus
hyper or hypopigmentated spots on skin. may go into eye and cause blindness - liver blindness
dx of onchocerca volvulus
microfilariea seen on skin biopsy
treatment of onchocerca volvulus
ivermectan
wucheraria bancrofti presentation?
elephantiasis and cough
intermediate host of wucheraria bancrofti
mosquito
dx of wucheraria bancrofti ?
thick blood smear
treatment of wucheraria bancrofti
diethylcarbamozine
toxicara canis complication?
blindness
treatment of toxicara canis?
albendozale
loa loa presentation?
transient angioedema, calibar swellings, and worm across eye
loa loa transmission?
deer fly
loa loa treatment?
diethylcarbamazine or albendazole
ecg findings of wolf parkinson white?
shortened PR interval, early upslope of QRS (delta wave), widened QRS
filtration fraction formula
GFR/RPF
presentation of IPEX
immunodeficiency with recurrent infections, autoimmune enteropathy, endocrinopathy and dermatitis
MHC II structure?
alpha and beta polypeptide chains
what drugs are class IB antiarythmics?
Lidocaine, mexiletine
what drugs are class IC antiarythmics?
flecainide, propafenone
what drugs are class IA antiarythmics?
procainamide, quinidine, disopyramide
what subtype of class I antiarthymics has the greatest Na binding affinity?
IC
what subtype of class I antiarthymics has the lowest Na binding affinity?
IB
what subtype of class I antiarthymics has has an intermediate Na binding affinity?
IA
chronic granulomatous disease has what deficiency?
NADPH oxidase
function of NADPH oxidase?
uses oxygen to make superoxide free radicals to kill pathogens in respiratory burst
patients with CPG are susceptible to which type of organism?
catalase positive
staph aureus, e coli, b cepacia and aspergillos are cat + or -?
+
what happens when someone with CGD is infected wiht a catalase + organism?
the organism uses catalase to break down ROS before the host immune system can use it –they can survive and cause severe infections
most common infection in CGD?
staph aureus
inheritance of CGD?
x linked recessive
what is a dihydrorhodamine test?
- used to diagnose CGD
- there will be no flurescence due to decreased superoxide and hydrogen peroxide which would oxidize a substance to be fluorescent
what is the nitroblue tetrazoleum test?
-nitroblue turns from yellow to blue in the presence of ROS. In CGD, it stays yellow
inheritance of IPEX?
x linked
mutation in IPEX?
loss of function of FOXP3, resulting in impaired development and function of regulatory t cells
presentation of IPEX
immunodeficiency with recurrent infections, autoimmune enteropathy, endocrinopathy and dermatitis
common skin findings of IPEX
eczema
GI presentation of IPEX?
autoimmune damage to enterocytes leads to chronic diarrhea
common endocrine pathologies of IPEX?
diabetes and thyroiditis
wiskott-aldrich syndrome inheritance?
x linked
wiskott-aldrich syndrome - which gene is mutated?
WAS - leads to problems with cytoskeleton - defective t cell signalling and interactions with APCs - impairs chemotaxis and phagocytosis
presentation of wiskott-aldrich syndrome?
recurrent pyogenic infections, eczema, thrombocytopenia
