Podcast
Questions and Answers
What is the most common reason for intraparenchymal hemorrhage in a patient with worst headache of their life?
What is the most common reason for intraparenchymal hemorrhage in a patient with worst headache of their life?
Which parasitic infection is definitively hosted by cats?
Which parasitic infection is definitively hosted by cats?
What is the characteristic presentation of a patient with parkinsonism?
What is the characteristic presentation of a patient with parkinsonism?
Which condition involves the degeneration of both the Upper Motor Neuron and Lower Motor Neuron of the cortical spinal tract?
Which condition involves the degeneration of both the Upper Motor Neuron and Lower Motor Neuron of the cortical spinal tract?
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What is the characteristic feature seen on CT/MRI in a patient with brain abscess?
What is the characteristic feature seen on CT/MRI in a patient with brain abscess?
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Which disease is characterized by waxes and wanes presentation and leads to blurred vision and diplopia?
Which disease is characterized by waxes and wanes presentation and leads to blurred vision and diplopia?
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What can rapidly correcting hyponatremia lead to, affecting the pons and potentially causing quadriplegia?
What can rapidly correcting hyponatremia lead to, affecting the pons and potentially causing quadriplegia?
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In a patient with chronic alcohol abuse, what condition is associated with thiamine deficiency presenting as an acute state?
In a patient with chronic alcohol abuse, what condition is associated with thiamine deficiency presenting as an acute state?
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Study Notes
Antimicrobial Therapy
- Pt with mod-severe PCP already on TMP-SMX, adjunctive tx is Prednisone
- DOC for strep throat is Penicillin V
- Pt given amoxicillin & clavulanic, no improvement, then given cephalosporin, gets better, most likely resistance is Altered PBP (not Blactamase)
- DOC for HIV pt with CMV retinitis is Ganciclovir
- Causative agent of pseudomembranous colitis is Clindamycin, treated with Metronidazole or Vancomycin
- MOA of causal drug for HIV pt with lactic acidosis (NRTI) is competitive inhib RT
- Treatment for Staph aureus in patient with renal failure is Nafcillin (due to biliary excretion)
- HAART contraindicated in psychiatric pt is Efavirenz
- Prophylaxis for bacterial meningitis for sick contact if NOT ceftriaxone is Rifampin or ciprofloxacin
- Specific enzyme inhibited by cilastatin is renal dehydropeptidase 1
- Treatment of hepatic encephalopathy is lactulose (1st line, especially if pregnant) or neomycin
Infectious Diseases
- Treatment of Borrelia/Rickettsia is Doxycycline
- EBV (HHV-4) causative agent, dsDNA, enveloped, replication in epithelial cells of oropharynx and salivary glands, latent in B-cell
- CMV -> Cotton Wool Retina & OWL EYE CYTOMEGALIC CELLS, seen in AIDS pts with CD4 < 50
- CMV retinitis presentation: progressive blurring of vision, floaters, flashes of light, possible subfoveal necrosis with overlying retinal hemorrhages
- Pt on ventilator, characteristic of infection is Fibrin Web appearance of CSF -> Tuberculous Meningitis
- Togaviridae -> Single Stranded Positive Sense RNA
- Flaviviridae -> Single Stranded Positive Sense RNA
Immune System
- Myasthenia Gravis -> Type II HSR -> Ab (IgG) against Ag present on cell surface leads to Ab mediated damage -> Muscle Weakness and Paralysis
- Hemolytic Transfusion Reaction -> Type II HSR -> Ab (IgG) against Ag present on cell surface leads to Ab mediated damage -> Hemolytic Anemia, Acute Renal Failure
- Systemic Lupus Erythematosus (SLE) -> Type III HSR (deposition of Ag-Ab complexes) -> Nuclear Antigens -> Nephritis, Arthritis, Skin/Other Lesions
- Serum Sickness -> Type III HSR (deposition of Ag-Ab complexes) -> Foreign Antigen -> Necrotizing Vasculitis, Arthritis, Nephritis
- Multiple Sclerosis -> Type IV HSR (delayed type HSR) -> targets protein in CNS and myelin sheath -> Demyelination with broad range of sensory and motor deficits
- Rheumatoid Arthritis -> Type IV HSR (delayed type HSR) -> targets unknown antigen in joint synovium -> Chronic arthritis with destruction of articular cartilage and bone
- Contact Dermatitis -> Type IV HSR (delayed type HSR) -> Environmental antigens -> Skin inflammation with blisters
- Allogenic Grafts -> transplant rejection between genetically different members of the same species
- Graft vs.Host Disease -> Donor tissue immunocompetent -> Donor T cells react to foreign Ag of host tissues -> recipient is immunodepleted due to whole body irradiation/chemo
- Patient with Achondroplasia has disproportionately short, shortened limbs/ribs with bulging forehead
Musculoskeletal Disorders
- Pt with Osteoarthritis -> gets a knee/hip replacement -> can lead to Septic Arthritis
- Rheumatoid Arthritis -> has Rheumatoid Factor (+), increased ANA, CRP, ESR, Increased Anti-CCP
- Complication of RA -> AA Amyloidosis
- Infectious Arthritis -> Hematogenous Seeding (extension from osteomyelitis)
- Osteosarcoma -> arises in metaphysis (of long bones)
- Medullary Cavity extends into the stalk -> Osteochondroma (benign cartilage capped tumor in metaphysis)
- Enchondroma -> has "O ring" sign, hyaline & myxoid cartilage production, chance of Chondrosarcoma
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Description
Test your knowledge on various immunological case studies including Tuberculous Meningitis, Myasthenia Gravis, and Hemolytic Transfusion Reaction. Explore different hypersensitivity reactions and their outcomes in the human body.
