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Questions and Answers

What is the primary role of activated complement proteins like C3a and C5a in inflammation?

They act as chemoattractants for immune cells. (correct)

They inhibit the inflammatory response.

They directly kill pathogens.

They degrade dead cells.

How do neutrophils contribute to the immune response?

By engulfing and digesting pathogens. (correct)

Through the formation of membrane attack complexes.

By releasing cytokines.

By regulating the complement cascade.

Which cell type is primarily responsible for clearing away dead cells during the immune response?

Eosinophils

Neutrophils

Macrophages (correct)

T Cells

What function do cytokines released by T Cells serve in the inflammatory response?

They can amplify or suppress inflammation. Signup and view all the answers

What is the role of the complement proteins like C1 inhibitor?

To regulate the complement cascade and prevent excessive inflammation. Signup and view all the answers

Which process is primarily associated with the resolution of inflammation?

Transition of macrophages to a pro-resolving state. Signup and view all the answers

What is the primary function of eosinophils and basophils in the immune system?

They release mediators that modulate inflammation and are involved in allergic responses. Signup and view all the answers

What happens to the complement system as inflammation resolves?

It is downregulated to prevent chronic inflammation. Signup and view all the answers

What ocular symptom is characterized by the drooping of one or both eyelids?

Ptosis Signup and view all the answers

What is a common bulbar symptom associated with muscle weakness?

Dysphagia Signup and view all the answers

Which examination finding indicates that pupils remain unaffected in MG?

Normal Pupils Signup and view all the answers

Which diagnostic approach shows a decremental response indicating myasthenia gravis?

Nerve Conduction Studies (NCS) Signup and view all the answers

What symptom is described as difficulty breathing due to weakness in respiratory muscles?

Dyspnea Signup and view all the answers

What is often revealed in chest imaging of patients with myasthenia gravis?

Thymic Abnormalities Signup and view all the answers

What characteristic finding on single-fiber EMG relates to muscle fiber response in patients with MG?

Increased Jitter Signup and view all the answers

What effect do acetylcholinesterase inhibitors have in diagnosing myasthenia gravis?

Improve muscle strength Signup and view all the answers

What increases the risk of seizure recurrence in children with febrile seizures?

Family history of epilepsy Signup and view all the answers

What should be evaluated in a post-seizure examination to assess for generalized tonic-clonic seizures?

Incontinence Signup and view all the answers

Which of the following is a common indicator of post-ictal states in seizures?

Post-ictal confusion Signup and view all the answers

What is crucial in differentiating between true epileptic seizures and seizure mimics?

Detailed history and physical examination Signup and view all the answers

In evaluating patients on antiepileptic medications, what is important to check?

Drug levels Signup and view all the answers

What physical finding might suggest a structural brain lesion as a cause of the seizure?

Focal deficits Signup and view all the answers

What type of injury should be looked for as evidence of convulsive seizures?

Tongue biting Signup and view all the answers

Which laboratory test is essential to rule out metabolic causes of a seizure?

Basic labs including electrolytes Signup and view all the answers

What is the role of renin in the body?

It converts angiotensinogen into angiotensin I. Signup and view all the answers

Where is renin produced?

In the juxtaglomerular cells of the kidneys. Signup and view all the answers

Under what conditions is renin released into the bloodstream?

Low sodium levels in the blood. Signup and view all the answers

What does angiotensin II do once formed?

Stimulates aldosterone release. Signup and view all the answers

What is the final effect of aldosterone on the kidneys?

Increases sodium and water retention. Signup and view all the answers

What enzyme converts angiotensin I to angiotensin II?

Angiotensin-converting enzyme (ACE). Signup and view all the answers

What type of feedback mechanism is primarily involved in the release of renin?

Homeostatic feedback. Signup and view all the answers

Which of the following is NOT a direct effect of angiotensin II?

Increased heart rate. Signup and view all the answers

What is the initial response of the pancreas to insulin resistance?

Increase insulin production Signup and view all the answers

What happens to beta cells over time due to insulin resistance?

They cannot keep up with insulin demand Signup and view all the answers

What is the effect of impaired glucose homeostasis on the liver?

The liver keeps producing glucose even when not needed Signup and view all the answers

What is the consequence of persistent hyperglycemia?

Complications in blood vessels Signup and view all the answers

How does the incretin effect change in type 2 diabetes mellitus (T2DM)?

Hormonal response to food intake is diminished Signup and view all the answers

What HbA1c level defines diabetes mellitus?

HbA1c ≥ 6.5% Signup and view all the answers

Which factor is not associated with increased estrogen exposure linked to breast cancer risk?

Regular exercise Signup and view all the answers

What role does obesity play in breast cancer risk?

Increases estrogen production via aromatization Signup and view all the answers

Study Notes

Complement System and Inflammation

Activated complement proteins like C3a and C5a serve as chemoattractants, recruiting immune cells to inflammation sites.
The complement system forms membrane attack complexes (MACs) that lyse bacterial cell walls, enhancing pathogen destruction.

Immune Cells and Role in Inflammation

Neutrophils: Perform phagocytosis to engulf and digest pathogens.
Macrophages: Continue phagocytosis, clearing pathogens and dead cells, including neutrophils.
T Cells: Release cytokines that modulate the inflammatory response by amplifying or suppressing it.
Eosinophils and Basophils: Play a role in allergic responses, releasing mediators to modulate inflammation.

Regulation and Resolution of Inflammation

Macrophages transition to a pro-resolving state, releasing anti-inflammatory cytokines like IL-10 and TGF-beta, which suppress ongoing inflammation.
Regulatory T Cells facilitate the shutdown of the inflammatory response and promote tissue healing.

Ocular and Bulbar Symptoms

Ptosis: Drooping of eyelids, noticeable with prolonged gaze.
Diplopia: Double vision that worsens with reading or prolonged visual tasks.
Dysarthria: Slurred or slow speech due to muscle weakness.
Dysphagia: Difficulty swallowing, posing choking risks.

Respiratory Symptoms

Dyspnea: Difficulty breathing from respiratory muscle weakness, potentially leading to respiratory failure.

Examination Findings in Myasthenia Gravis

Normal Pupils: Pupils remain unaffected, unlike other neuromuscular disorders.
Preservation of Autonomic Functions: Functions such as heart rate and digestion remain intact.
Deep Tendon Reflexes: Generally preserved even in muscle weakness cases.

Diagnostic Approach for Myasthenia Gravis

Nerve Conduction Studies (NCS): Characterized by a decremental response during repeated stimulation.
Electromyography (EMG): Shows increased jitter, representing variability in muscle fiber response to nerve signals.
Response to Acetylcholinesterase Inhibitors: Positive response to medications supports diagnosis.
Chest Imaging: May reveal thymoma or thymic hyperplasia related to the disease.

Physical Examination After Seizures

Incontinence: May occur during or after generalized tonic-clonic seizures.
Oral Trauma: Look for tongue biting or other injuries indicative of convulsive seizures.
Post-Ictal Confusion: Assessment of mental status after a seizure reveals confusion.

Differential Diagnosis of Seizures

Distinguish between true seizures and mimics, such as syncope, migraines, or psychogenic seizures, using detailed history and examination findings.

Diagnostic Evaluation for Seizures

Medication Levels: Confirm adherence to antiepileptic treatment through drug level checks.
Laboratory Tests: Basic tests including electrolytes and toxicology screens help rule out metabolic causes.

Pathophysiology of Diabetes

Beta Cell Dysfunction: Early compensation by the pancreas fails over time, leading to decreased insulin output due to glucotoxicity and lipotoxicity.
Impaired Glucose Homeostasis: Liver continues to produce glucose despite resistance, while muscle and fat uptake declines.
Persistent Hyperglycemia: Chronic high blood sugar leading to vascular complications in organs such as eyes, kidneys, and heart.

Hormonal Influences on Breast Cancer Risk

Increased Estrogen Exposure: Factors like hormone therapy and reproductive history elevate risks.
Obesity's Role: Fat cells increase estrogen production, contributing to breast cancer likelihood.

Renin-Angiotensin System Overview

Renin Production: Enzyme from juxtaglomerular cells in the kidneys, triggered by low blood pressure, decreased blood flow, or low sodium levels.
Action of Renin: Converts angiotensinogen into angiotensin I, initiating the pathway for blood pressure regulation.
Angiotensin II Effects: Causes vasoconstriction and stimulates aldosterone release, increasing sodium and water retention to raise blood pressure.

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