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85 Cards in this Set
- Front
- Back
what is the best test for nutritional status?
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prealbumin
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what is the difference in marasmus and kwashiorkor?
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marasmus is low Kcal intake and growth failure but kwashiorkor is normal Kcal intake but decreased protien. These pts will have fatty livers, edema and diarrhea whereas in marasmus they are emanciated
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malnourished young child has alternating streaks of light and dark color in hair (flag sign) and rash that looks like "flaky paint". dx?
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kwashiorkor
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anorexia.
1. how much below normal is weight? 2. what hormone imbalances are there and what are the complications of those imbalances? 3. what is treatment? |
1. >15% below normal weight
2. no gnrh so no FSH/LH which causes amenorrhea and osteoporosis. Also have increased cortisol, increased ghrelin and growth hormone but decreased leptin 3. SSRI and psychotherapy |
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bulemia.
what is the electrolyte abnormality? |
1. hypokalemia metabolic alkalosis
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What are the fat soluble vitamins?
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ADEK
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pt presents with night blindness (nyctalopia) and bitots spot of cornea. what is problem and what ist he cause?
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Vit A deficiency, from malabsorption or starvation.
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pt presents with elevated calcium, papilledema, yellow skin, fulminant liver failure. what is likely cause
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high vit a
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classic test question...."man eats polar bear liver and then turns yellow." what is cause?
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vit a toxicity.
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vit d.
1. what are causes for deficiency? 2. how does it present in kids? in adults? 3. what is classic physical exam findng on ribs? 4. what electrolyte abnormality is present? 5. what is seen on xray? 6. what is most accure measure of body pool of vit d? |
1. malabsorption, renal failure
2. rickets in kids, osteomalcia in adults 3. rachitic rosary 4. hypocalcemia with tetany 5. loosers lines on x ray aka milkmans fractures 6. Vit D2 is best test |
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1. what are vit k dependent factors?
2. what does epoxide reductase do? 3. what is the first factor to decrease with coumadin? |
1. 2, 7, 9, 10 and C&S
2. keeps vit K1 in active form and active vit K 3. factor 7 and then protein C |
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what are causes of Vit K def in adults?
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malabsorption, cirrhosis, ileal dz, and antibiotics, coumadin
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pt presents with hemarthroses, poor wound healing, gingival hyperplasia and fatigue, malaise and bleeding from gums. what is dx?
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Vit C deficiency causing scurvy
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what is the role of vit c in the body?
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enhances folate adn iron absorption
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what are symptoms of low thiamine?
what are causes of low thiamine? what is important in treatment of low thiamine? |
sx are CAN-->confusion/confabulation, ataxia, nystagmus
--alcohol leading to deficiency can cause beriberi with wernickes and korsakoffs --give glucose first then thiamine |
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what vitamin is important in the TCA cycle for making ATP with pyruvate and acetyl CoA?
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thiamine (B1)
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pt has cheilosis and magenta tongue?
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low riboflavin (b2)
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what is the cause of low B12?
what are the symptoms? what lab finding will be on boards? |
1. from pernicious anemia or gastric absorption problem.
2. peripheral neuropathy 3. hypersegmented polys |
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pt presetns wtih diarrhea, dermatitis, and dementia and a rash around her neck (cassals necklace). what is dx and cause?
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pellegra from niacin deficiency
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what is the role of B6 (pyroxidine) in the body?
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heme synthesis and neurotransmitters
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pt being treated with Isoniazid presents with anemia and peripheral neuropathy. what is the cause?
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low B6
*hoskison says b6 treatment doesnt prevent the liver dz of INH |
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what is the number one cause of deficiency of trace elements?
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doctor error in TPN ordering
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pt presents with acrodermatitis, enteropathica, poor wound healing. what is cause?
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zinc def
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1. how does low mag effect PTH and ca?
2. what are the causes of low mag? 3. what are the symptoms? |
1. causes low PTH and low ca
2. etoh , cisplatin, PPIs, diarrhea, 3. tetany, seizures, mm weakness |
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pt with CRF presents with mm flaccidity. what is most likely cause?
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hypermag
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what is a common finding in copper def?
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aneurysms
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chromium deficiency causes what?
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glucose intolerance
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selenium def caues what?
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cardiomyopathy
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what kind of cancer do nitrosamines cause?
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gastric
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pt with osteoporosis should have how much ca and vit d?
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1200-1500mg ca and 400-800 IU vit d
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what are K and Na requirements per day?
Kcal requirement? |
80meq Na
44 meq K 20-25Kcal/kg |
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what is the function of B cells?
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bacterial pathogens especially encapsulated and antibody production
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what is the fxn of t cells?
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type 4 hypersensitivity, regulates b cells, intracellular pathogens like TB and fungi
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what is natural killer cell fxn?
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killing virally infected and tumor cells
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what lab should you order to check b cell fxn?
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total immunoglobulin level
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what test should you order to check t cell fxn?
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monoclonal markers (T3, T4, etc), skin testing
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peripheral T cells with antigen recognition site are called what?
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CD3
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what is the role of CD4 helper T cells.
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help in tupe 4 rxns and make IL-2 to activate macrophages to activate CD8 cells
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what is the role of CD8 T cells?
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cytotoxic, killing pathogens
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are the following B cell, T cell or mixed disorders?
1. bruton's 2. selective IgA 3. Digeorge 4. X linked lymphoproliferative 5. wishkott aldrich 6. CVID (common variable immune def) 7. SCID 8 ataxia telangiectasia |
1. B cell
2. b cell 3. t cell 4. b cell 5. mixed 6. b cell 7. mixed 8. mixed |
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pt presents with recurrent infections like pneumonia, giardia, and lymphomas and is dx with burtons agammaglobulinemia.
1. how is it acquired 2. what is the path/ |
1. x-linked recessive
2. failure of pre-b cells to b cells |
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1. what is the cause of CVID. These pts also have recurrent infections with giardia, but will have granulomas not lymphomas like in burtons.
2. when do symptoms usually surface? 3. should they get live vaccines |
1.failure of B cells to plasma cells
2. 2-3 decade 3. no live vaccines |
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what is the mot common hereditary immune def?
what other def is associated? |
selective IgA def
associated with IgG2 and 4 |
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pt has recurrent sinopulmonary infections and GI infections. and anaphylaxis to blood transfusions. what is cause?
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IgA def
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in diGeorge what is the cause and sx?
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no parathyroids or thymus so recurrent infections and low calcium causing tetany
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deficiency of adenosine deaminase is what disorder?
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SCID
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pt has thrombocytopenia, eczema, recurrent infections, and lymphomas and high IgE level. what is dx?
how is it acquired? |
wiskott aldrich
x linked recessive |
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2 year old pt has cerebellar ataxia and high AFP. dx?
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ataxia telangiectasia
autosomal recessive |
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what is the best test of th complement system?
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CH50
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in post strep and lupus nephritis C3 is high or low?
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low
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1. what are symptoms of C1 esterase inhibitor deficiency?
2. how is it acquired 3. how to screen for it? 4. what is treatment? |
1. angioedema
2. hereditary autosomal dominant or acquired with ACE-Is. 3. screen is decreased C4 4. androgen is tx and FFP has C1 esterase inhibitor in it |
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what infection is seen with C5-8 def?
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GC infections
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HLA-B27 gene seen in what?
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ankylosing spondylitis
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HLA-DR3/4 gene seen in what?
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type 1 DM
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what type hypersensitivity rxn is this?
1. goodpastures? 2. allergy to dust mite feces (#1 cause) or cats 3. graves, myasthenia gravis? 4. serum sickness, farmers lung 5. anaphylaxis to bee stings 6. ABO incombatibilty 7. contact dermatitis to nickel or poison ivy 8. PPD testing 9. lupus 10. elevated IgE 11. ITP, autoimmune hemolysis |
* I only did the bolded ones and some other random ones but not all inclusive. pg32 on hoskisons
1. 2 2. 1 3. 2 4. 3 5. 1 6. 2 7. 4 8. 4- delayed type 9. 3 10. 1 11. 2 |
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on boards how to dx type 1 hypersensitivity?
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scratch test- causes histamine release with a wheal and flare rxn
DONT pick RAST testing |
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high levels of what is a marker for anapylaxis?
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tryptase
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what is tx of type 2 hypersensitivity rxns?
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plasmapheresis or steroids
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what are causes of hemorrhagic arthritis?
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scurvy and hemophilia
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synovial fluid with >100k cells and mostly WBCs is what?
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septic arthritis
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synovial fluid with monosodium urate crystals that are needle shaped and negatively birefringent.
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gout
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synovial fluid that is calcium pyrophosphate crystals and rhomoid shape and +birefringent is what?
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pseudogout
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what is the mcc of septic arthritis?
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N. gonorrhea then staph aureus
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what is a common cause of osteo and septic joint in sickle cell?
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salmonella
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what bug are you worried about in cat bites and what is tx?
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pasteurella tx with augmentin
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if septic arthritis from sporotrichosis what is tx?
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KI
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pt gets bit by iguana and gets septic arthritis. what is the bug?
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salmonella
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if pt has low synovial glucose what is the likely dx
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septic or RA
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kid has joint pain, fever, rash, lymphadenopathy, hepatosplenomegaly.
what is dx? tx? lab findings? |
juvenile RA
tx with ASA RF or ANA negative |
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what is the mechanism for gout?
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decreased excretion of uric acid
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what are causes of secondary hyperuricemia?
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diuretics
DM excess cell states like cancer or hemolysis increased gap metabolic acidosis |
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acute gouty flares involving the big toe are called what?
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podagra
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what is tx for an acute gout attack? and for chronic tx?
what is the tx goal? |
indomethacin or colchicine
allopurinol not in acute attack uric acid level less than 6 is goal |
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what are other terms for pseudogout?
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CPPD calcium pyrophosphate dihydrate crystal deposition
chondrocalcinosis |
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1. What joints are involved in pseudogout?
2. what is tx of psuedogout? 3. what other disorders/diseases is psuedogout associated with ? |
1. knee, MCPs
2. tylenol and NSAIDS 3. hyperparathyroid, hypothyroid, OA, RA, hypophosphatemia, hypomagnesemia, hemachromatosis |
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what is distinct about arthritis with hemochromatosis?
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it involved 2nd and 3erd MCPs with classic "parrot beak" osteophytes
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what are examples of seronegative arthritidies?
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anklyosing spndylitis, reiters, psoriatic, enteropathic
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young male pt has sacrolitis, restrictive lung dz, and aortic valve problems?
1.what is dx? 2.what lab finding? 3. what is tx? |
1. ankylosing spondylitits
2. HLA-B27 3. indomethacin, maybe TNF alpha or methotrexate |
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pt presents with urethritis, conjunctivitis, mucocutaneous involvement and arthrits.
1. what is dx? 2. what are possible causes 3. what is tx? 4. what are the two classic skin manifestations in reiters? |
1. reiters
2. chlamydia, shig/salmonella/campylobacter 3. NSAIDS 4. balanitis circinata and keratoderma blennorrhagicum |
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pt has sausage digits and arthritis mutilans and is dx with psoriatic arthritis.
what is tx? |
NSAIDs, MTX, TNF drugs
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pt with IBD complains of joint pain what is dx and tx?
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enterohepatic arthritis and tx with sulfasalazine
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septic arthritis
1. how is it acquired? 2. what joint is usually invovled 3. what is #1 overall cause 4. what complement deficiencies are associated with it? |
1. hemotogenous
2. knee 3. gonococcus 4. C5,6,7,8 deficiency |
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ANA patterns
1. if pt has rim pattern ANA what is the dx you should think of ? 2. homogeneous pattern? 3. speckled pattern? |
1. SLE with renal involvement, anti-ds DNA
2. nothing, continue work up 3. could mean several things |
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if specked ANA pattern think of the following associated antibodies. what dz goes with each ab?
1. anti-Sm (smith) 2. anti-RNP 3. anti Scl-70 4. anti JO-1 5. anti-Ro(SS-A)/La (SS-B) 6. nucleolar 7. anti-histone |
1. SLE
2. mixd connective tissue disease 3. scleroderma 4. dermato/polymyositis 5. sjogrens 6. progressive systemic sclerosis 7. drug induced |
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match the follow antibodies with the disease associated?
1. anti-acetylcholine receptor ab 2. anti-centromere 3. c-ANCA and anti-porteinase-3 4. anti-gliadin/endomysial/gluten 5. tissue-transglutamase (tTG) 6. anti-GMB 7. anti-neutrophil 8. anti-insulin and GAD |
1. mysthenia gravis
2. CREST 3. wegners 4. celiac 5. celiac 6. goodpastures 7. felty's 8. Type 1 DM |