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166 Cards in this Set
- Front
- Back
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1 million deaths/year
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malaria
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4th leading cod in children
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malaria
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parasites infect liver first, then RBC
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malaria
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which bug in malaria attaches to endothelium
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plasmodium falciparum
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giemsa stain is gold standard
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malaria
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spleenomegaly and jaundice
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malaria
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what do you tx malaria with
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oral chloroquine
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what disease protects you from malaria
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sickle cell anemia
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jaundice in malaria indicates what form of anemia
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hemolytic
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aids affects how many in US
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1 in 300
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aids is the ___most common cod in ___ to ___ year olds
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5th, 25-44
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_____ are 7 times more likely to get aids than _____
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blacks, whites
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CMV retinitis 30% of the time with cotton wool spots
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aids
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western blot is gold standard for
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aids
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4 stages of aids
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1) asymptomatic 2) upper respiratory tract infection 3) chronic diarrhea, severe bacterial infection, TB 4) toxoplasmosis, thrush, Kaposi's sarcoma
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inflammation of sacroiliac joint
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ankylosing spondylitis
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increased alkaline phosphatases 50% of the time
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ankylosing spondylitis
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ankylosing spondylitis is more common in white _____ with symptoms starting around age ____ to ____
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males, 15-40
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RF form (neg/pos) associated with what gene 90% of the time in anklosing spondylitis
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negative, HLA-B27 90% of the time
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organ most commonly affected in ankylosing spondylitis
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the eye
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anterior uveitis ___% of the time with ankylosing spondylitis
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40%
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how do you dx ankylosing spondylitis
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x-ray
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how do you tx ankylosing spondylitis
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NSAIDS
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bisphosphonates
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ankylosing spondylitis
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calcification of the spinal nlgaments is called _________ __________ and is found in what disease
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bamboo spoine; ankylosing spondylitis
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which organ is least affected in ankylosing spondylitis
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lung
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elevated IG-A
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ankylosing spondylitis
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possibly association with Klebsielle bacteria
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ankylosing spondylitis
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1.5 million in US affected
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parkinson's
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____% damage of ____ ____ indicates what disease
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80% damage of substantia nigra indicates Parkinson's
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kapavata
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parkinson's disease
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resting tremor, bradykinsia, shuffling gait, weak face, muscle rigidity
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parkinson's disease
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to diagnose with parkinson's, pt must have at least 2 of:
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genetic counseling, neuroimaging, olfactory testing, autonomic testing
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parkinsonism can be caused by
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supranuclear palsy, corticobasal degeneration, multiple system atrophy
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____ decreases L-Dopa effect in Parkinson's
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protein
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Parkinson's has an abnormal reading on the
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VEP and ERG
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decreased estrogen and B-12
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parkinson's
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5 gene mutations of parkinson's
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Alpha-synuclein, UCTH, Parkin, dj1, sca2
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old silk road disease
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behcet's disease
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behcet's is common in what area
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middle east - iraq to mongolia
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incidence of behcet's
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1:15,000 in Western (females more likely)
1:2000 in mid-east (males more likely) |
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what gene is behcet's associated with
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HLA B51
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how do you diagnose behcet's
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aphthous ulcers 3 times in 12 months plus at least 2 of: genital ulcers, skin lesions, + pathergy test, eye inflammation/loss of vision
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associated with pulmonary aneurysms, arthritis 50% of the time, and CNS defects
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Behcet's Disease
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first symptoms of Behcet's Disease
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Apthous Ulcers - lasts 10-14 days
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what are chrysops
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silacea (mango) and dimidiata (deer) flies, vectors for loa loa filaria
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where is loa loa filaria located
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subcutaneous tissue and sub conj in eye
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tx with diethylcarbamazine
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loiasis
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increased IgE, eosinophilia, calabar swellings
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loiasis
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rain forrest/swamps
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loiasis
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how many affected with loiasis
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12-13 million
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diurnal cycle in blood
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loiasis
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how many infected with onchoceriases
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17.7 million
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how much blindness with onchoceriasis
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270,000
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used to be the leading cause of preventable blindness
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onchoceriases
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infectious disease caused by nematode (volvulus)
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onchoceriases
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vector for onchocerca volvulus
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simulium spp (black fly)
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exam findings for onchoceriases
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maculopapular rash, erosions, lichenification, leopard skin, onchocercomas, hanging grown, lymphoedema
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how many affected with loiasis
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12-13 million
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where in the eye are microfilariae found from onchoceriases
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stroma and AC
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choroidoretinal lesions
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onchoceriases
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diurnal cycle in blood
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loiasis
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how many infected with onchoceriases
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17.7 million
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how much blindness with onchoceriasis
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270,000
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used to be the leading cause of preventable blindness
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onchoceriases
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infectious disease caused by nematode (volvulus)
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onchoceriases
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vector for onchocerca volvulus
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simulium spp (black fly)
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exam findings for onchoceriases
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maculopapular rash, erosions, lichenification, leopard skin, onchocercomas, hanging grown, lymphoedema
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where in the eye are microfilariae found from onchoceriases
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stroma and AC
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choroidoretinal lesions
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onchoceriases
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how many affected with loiasis
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12-13 million
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diurnal cycle in blood
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loiasis
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how many infected with onchoceriases
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17.7 million
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how much blindness with onchoceriasis
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270,000
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used to be the leading cause of preventable blindness
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onchoceriases
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infectious disease caused by nematode (volvulus)
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onchoceriases
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vector for onchocerca volvulus
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simulium spp (black fly)
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exam findings for onchoceriases
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maculopapular rash, erosions, lichenification, leopard skin, onchocercomas, hanging grown, lymphoedema
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where in the eye are microfilariae found from onchoceriases
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stroma and AC
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choroidoretinal lesions
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onchoceriases
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ivermectin is DOC
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onchoceriases
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over exposure to cortisol
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cushing's syndrome
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cushin's affects:
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15:1,000,000. females 5x more than males, age range 20-50
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hormone process to create cortisol:
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hypothalmus (CRH) > pituitary gland (ACHT) > adrenal gland (cortisol)
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triad for cushings
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moon face, buffalo hump, truncal obesity
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transspenoidal adenomectomy
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cushing's
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cushing's is usually of what type of cause
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exogenous or iatrogenic
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what is cicatricial pemphigoid
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blistering and scarring of the mucous membranes due to antibodies that attack the basement membranes
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extreme dry eye d/t distruction of goblet cells
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cicatricial pemphigoid
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incidence of Cic pemph
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1:20,000. females (2:1) males
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how often are the eyes involved in cicatricial pemphigoid
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75% of the time
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stages of cicatricial pemphigoid
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1) chronic conjunctivitis and white striae 2) scarring and shortening of fornices 3) symblepharon 4) vascularization and keritinization of ocular surface leading to blindness
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glaucoma meds + certain HLA markers may = ?
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cicatricial pemphigoid
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dapsone is doc for
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cictricial pemphigoid
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30% progress to blindness in
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cicatricial pemphigoid
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type II autoimmune disease
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cicatricial pemphigoid
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what serum is found in cicatricial pemphigoid
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IgG
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inflammation of terminal ilium
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crohn's disease
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non-caseating granulomatous inflammation
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crohn's disease
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what genes are associated with crohn's disease
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CARD15 and XBP1`
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transmural inflammation and fistulae
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crohn's disease
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anemia and B-12 deficiency
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crohn's disease
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2 diseases we studied with aphthous ulcers
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behcet's and crohn's
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most common ocular finding of crohn's
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anterior uveitis
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three categories of presentation in crohn's disease
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stricturing, penetrating, inflammatory
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ddx b/w crohn's and ulcerative colitis:
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ASCA/ANCA
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hydrocortisone and 5ASA
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crohn's
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paneth cel lmetaplasia
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crohn's
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what is the immune system doing in crohn's
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overactive TH1 cytokine response
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what are 2 things that we talked about that increase 'flare-ups' in crohn's
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smoking and oral contraceptives
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incidence and age range of crohn's
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7:100,000. teens-20's and 50-70
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incubation period of gonococcal
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3-19 days
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is niesseria more common in men/women; white/black
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1.5x more likely in men, black
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what type of bacteria is niesseria
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gm- intracellular diplococcus
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chocolate or thayer-martin agar
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gonococcal infection
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major mucopurulent discharge
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gonococcal infectioini
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prophylaxis for babies eyes
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erythromycin to prevent gonorrhea
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gene for DM
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HLA-DR
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gestational diabetes
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4% get it, goes away in 6 weeks after birth, but 60% of those women will get type II later on
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most common cause of non-traumatic amputation
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DM
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in type I DM, what cells are attacked, creating an insulin deficiency
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islets of langerhans, and beta cells in the pancreas
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type II DM is caused by the body
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not recognizing insulin or not creating enough of it
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death in DM usually comes from
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heart disease/stroke
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death in aids usually comes from
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1) infection 2) secondary neoplasms 3) neurological defects
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leading cause of blindness
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DM d/t macular edema
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DM tests
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fasting: >126
oral tolerance: >140 plasma: >200 A1C wants <7% |
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what causes down's syndrome
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3 copies of chromosome 21. 3% is d/t translocation, 2% is mosacism.
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1 in how many births has downs
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800
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age of mother that starts to influence down's
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35
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how many clinical findings needed to diagnose down's
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8
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ocular findings of down's
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blepharitis, keratoconus, cataracts, accommodative ET, brushfield spots on iris, nystagmus
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down's screening tests:
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decreased AFP, decreased u-E3, increased beta subunit of hCG, increased Inhibin A, presence of PAPP-A markers
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Ddx needed in down's
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FAS, fragile X syndrome, Eagle Barrett, Cerebral Palsy
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Ultrasound screening for down's looks for:
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thick neck, herniated bowel, enlarged bladder (megacystitis), absent nasal bone. look at 11 and 14 weeks
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do not give what drug to down's pts
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atropine
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how many people in US affected by hypothyroidism
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5 million
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lithium based mood stabilizers can cause:
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hypothyroidism
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wolff-chaikoff effect associated with
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hypothyroidism
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sign of hertoghe
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hypothyroidism
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2 forms of hypothyroidism
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cretinism and myxedema (gull's disease)
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T4 produced at a rate of __ : __ compared to T3
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20:1
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cold intolerance, depression, goiter, bradycardia, thinning of outer eyebrow, weight gain, hoarse voice
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hypothyroidism
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most common form of hypothyroidism
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hashimoto's thyroiditis
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tx = levothyroxine for:
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hypothyroidism
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what can you measure for thyroid function
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prolactin
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secondary hypothyroidism originates in
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the pituitary gland
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tertiary hypothyroidism:
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originates in the hypothalamus and is caused by dopamine
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dopamine can cause what type of hypothyroidism
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tertiary
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what hormone levels do you find in hashimoto's thyroiditis
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decrased TSH but increased T4 and T3
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what hormone levels do you find in sub-clinical hypothyroidism
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decreased TSH but normal levels or T4 and T3
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polyneuralgia rheumatica is associated with what disease, what percent of the time
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GCA, 20%
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GCA us more common in men/women of what age and descent
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women, 50 or older, Scandinavia
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what countris make up scandinavian descent
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norway, sweden, denmark
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polymorphisms of the HLA antigen class II region is a risk factor for
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GCA
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infectious factors for GCA
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Mycoplasma pneumoniae, parvovirus B19, parainfluenze virus, chlamydia pneumoniae
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main symptoms for GCA
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headache, polymyalgia rheumatica, jaw claudication, scalp sensitivity
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formulas for ESR
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age/2 for men, age+10/2 for women
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only diagnosis for GCA is
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biopsy
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GCA often affects the:
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ascending aorta, especially the external carotid
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GCA is _________ inflammation of what sized arteries
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granulomatous inflammation of large and medium arteries
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GCA causes thickening in the
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tunica intima
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GCA is caused by polymorphisms of what genes
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HLA-DRB 101 and 104
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prevalence of FAS
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1:500
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maternal risk age for FAS is
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>30
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most critical gestational time
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3-8 weeks (embryonic period). main organs are being made
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3 characteristics that indicate FAS rather than down's
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small palpebral fissures, indistince philtrum, thin vermilion border
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