Week 2 bb Q revision Flashcards
organism
- faeco-oral route
- epidemics
- shelffish from seawater containing sewage
Hepatitis A
organism
- distal colon
- acute mucosal inflammation and erosion
- person-to-person contact
- fever, pain, diarrhoea and dysentry
Shigella
organism
- ileum, appendix and colon
- invades peyer patches
- mesenteric lymph node enlargement with necrotising granulomas
- complications = peritonitis, pharyngitis, pericarditis
Yersinia
organism
- cysts/trophozoites founds in faeces
- complications of amoebic coltis, liver abscess, pleuropulmonary/cerebral amoebiasis
Entamoeba histiolytica
This type of vaccine is generally effective with one dose, can cause severe reactions in immunocompromised and are prone to destruction by heat or light.
Live attenuated vaccines
Which vaccine is known to revert back to its original disease-causing form?
Live oral polio
This type of vaccine can’t cause disease even in an immunodeficient person, they require boosters and it is mostly humoral immunity stimulated.
Inactivated vaccines
Mnemonic for live attenuated vaccines
BOMb YO IV
BCG
Oral polio
MMR
Yellow fever
Oral typhoid
Influenza
Varicella
An antigen assembled in a multimeric form and saponin that provokes a strong serum antibody response.
Immunostimulatory complexes (ISCOMS)
Conjugate vaccines given for …
Hib, pneumococcal and meningococcal disease
Live attenuated vaccine that is no longer given as standard in the UK since the rates of reverse mutation are higher than those of active disease.
Polio (Sabin)
Sterility in adult males may occur if a particular vaccine is not administered. Which one is it?
Mumps
Mnemonic for inactivated vaccines?
CARP Fish
Cholera
hep A
Rubella
Polio
Flu
A recombinant subunit vaccine
Hep B
A water-in-oil emulsion containing mycobacterial cell wall components that could be used to increase the immune response of a vaccine.
Freund’s adjuvant
This form of immunity is induced by vaccination.
Active immunity
This form of immunity is induced by transfer of ready-made antibodies.
Passive immunity
Left sided colicky pain
Relieved by defecation
Constipated stools passed
Diverticular disease
Left sided abdominal pain
Relieved by defecation
Tender abdomen and left iliac fossa
Pyrexial with raised WCC and ESR.
Diverticulitis
Young patient Right iliac fossa pain diarrhoea weight loss oedematous reddened ileum with transmural inflammation and granulomas
Crohn’s
large volumes of mucous
cauliflower-like mass covered by dysplastic columnar epithelium in rectum
villous adenoma
Transmural and non-caseating granulomas
Crohn’s
Woman with lower abdominal pain and fever. Using an IUD for 3 years.
Endometritis
A triad of
- nail dystrophy
- leukoplakia
- cutaneous manifestations (such as tan-to-grey hyperpigmented patches)
Dyskeratosis Congenita
- glucocerebrosidase deficiency
- hypersplenism
- Ashkenazi Jews
Gaucher’s disease
Dapsone use causes haemolysis in what group of patients?
G6PD deficiency
What condition is Donath-Landsteiner positive?
Paroxysmal Cold Haemoglobinuria
Mononuclear spot test
EBV
Paul-Bunnell test
EBV
OR! a false positive could be parvovirus B19. (remember Paul-Bunnell = “PB” = Parvovirus B19
Anaphylaxis post-transfusion
IgA deficiency
Donor plasma contains white cell antibodies incompatible with recipient’s white cells.
Chills, fever, dry cough and SOB with cardiac failure.
TRALI
Post-transfusion Fever erythematous macular papular rash Cough Abdo pain Vomiting Diarrhoea
TA-GvHD
Post-transfusion
mild symptoms of fever and rigors
within 24 hours
Febrile non-haemolytic transfusion reaction (FNHTR)
Post-transfusion
Severe symptoms of fever, rigors, tachycardia
Bacterial contamination
Post-transfusion
diffuse erythematous rash which responds well to chlorpheniramine/acrivastine.
Allergic reaction to transfusion
One week post-transfusion
severe bruising
low platelets
Post-transfusion purpura
Acid Phosphatase
Prostatic cancer
lacunar histiocytes
nodular sclerosis Hodgkin’s lymphoma
popcorn cells
nodular lymphocyte predominant HL
small cell with hyperlobulated nucleus and small necleoli
aka popcorn cells
a/w nodular lymphocyte predominant Hodgkin’s lymphoma
Reed-sternberg cells
Hodgkin’s Lymphoma
A cell whose cytoplasm retracts when fixed in formalin so there appears to be cells lying with empty spaces between them
aka lacunar (the spaces) histiocytes a/w nodular sclerosis Hodgkin's lymphoma
Poisoning leading to inhibition of acetylcholinesterase along with symptoms: salivation lacrimation urination defecation gi upset emesis
Organophosphate
Anti-smooth muscle antibody
Autoimmune hepatitis
Mycophosphorylase deficiency
Glycogen storage disease type V - McArdle’s syndrome
Alpha galactosidase A deficiency
Fabry’s disease
Young child.
Very thin.
Distended abdomen.
Nutrient deficiency?
Protein
Alcoholic
Neurological signs
Nutrient deficiency?
Thiamine (B1)
Diarrhoea
Dermatitis
Dementia
What nutrient deficiency?
Niacin (B3)
condition is called Pellagra, characterised by the three D’s
Psychological symptoms
Neurological burning/tingling in peripheries
What nutrient deficiency?
B12
Looks like a malabsorptive condition
They’re also bleeding
What nutrient deficiency?
Vitamin K
Seborrhoeic dermatitis eruption Atrophic glossitis Angular chelitis Sideroblastic anaemia What nutrient deficiency?
B6
Radioiodine scan high uptake locally
Toxic nodules - multi or single
Radioiodine scan high uptake diffuse
Graves
Raised calcitonin
Medullary thyroid cancer
Hurthle cell
Hashimoto’s thyroiditis
Askanazy cell
Hashimoto’s thyroiditis
Giant cell thyroiditis aka …
De Quervain’s thyroiditis or subacute granulomatous thyroiditis
Therapy for attack of acute intermittent porphyria?
Haem arginate
Anti-inflammatory drug that is contra-indicated in patients with porphyria
Diclofenac
Haem arginate
Used to treat attack of acute intermittent porphyrias
Drug that can result in chronic porphyria
Alcohol
Drug that is contra-indicated in porphyria (not an NSAID)
Co-trimoxazole
Porphobilinogen deaminase deficiency
Acute intermittent porphyria
Neurotoxic product of heme breakdown –> neurovisceral damage
5-aminolevulinic acid
Enzyme catalyses rate-limiting step of heme breakdown
ALA synthase
Products of heme breakdown –> photosensitivity damage in certain porphyrias
Activated porphyrins and oxygen free radicals
