Internal Medicine 2

Front 1

HIV components/features

Back 1

# Segmented enveloped virus

# 2 RNA strands

# 3 enzymes : Reverse transcriptase, Protease and Integrase

# gp 120

Front 2

Can HIV can be transmitted through saliva and kissing?

Back 2

No it can't

Front 3

HIV transmission

Back 3

# Blood

# Sexual intercourse (Semen & Vaginal fluid)

# Vertical transmission (Vaginal delivery, breast milk)

Front 4

HIV classification by CDC

Back 4

Front 5

HIV classification by CDC

Back 5

Front 6

Typically HIV symptoms

Back 6

# Fever

# Fatigue

# HIV wasting syndrome (Weight loss and Diarrhoea of unidentifiable cause)

Front 7

Oral conditions associated with HIV can be divided into 5 groups, what are they?

Back 7

Oral conditions due to

1) Microbiological infections (bacteria, fungi like oral thrust, etc)

2) Oral neoplasms

3) Lesion of unknown cause

4) Conditions associated with HIV drugs

5) Neurological conditions

Front 8

Systemic vs Local anaphylactic reaction

Back 8

1) Systemic : Penicillin reaction, bee & wasp stings, scorpion stings

2) Local (atopy) : Asthma, atopic dermatitis, hay fever, Reaction to foods, nuts

Bee stings can be local but in case of patients that are allergic to bee stings, it's systemic

Front 9

Types of hypersensitivity reactions and their time of onset

Back 9

# Type I & II - 15-30 mins after exposure

# Type III - 3-10 hours

# Type IV - lasts hours or days

Front 10

Examples of cytotoxic (type 2) hypersensitivity reaction

Back 10

Front 11

What drugs are employed in type 3 hypersensitivity to prevent antibody formation

Back 11

Corticosteroids

Front 12

Type 4 hypersensitivity is the reaction seen in which kind of microbiological agents

Back 12

Intracellular microbes (viruses, tuberculosis, parasites, fungi)

Front 13

Examples of type 4 hypersensitivity

Back 13

# Tuberculin skin test & TB

# Allergic Contact dermatitis (different from atopic dermatitis)

# Graft rejection

Front 14

Types of autoimmune diseases

Back 14

# Organ specific

# Organ non-specific (systemic)

Front 15

Organ specific autoimmune disease

Back 15

Front 16

Organ non-specific autoimmune diseases

Back 16

You're wondering why lupus is autoimmune. Remember the antibodies are formed against your body's own DNA molecules

Front 17

Types of lupus erythematosus

Back 17

# Systemic lupus erythematosus (SLE)

# Discoid lupus erythematosus (DLE; primarily affects the skin involving the cheeks and nose)

# Drug-induced lupus erythematosus

# Neonatal lupus erythematosus

Both systemic and discoid lupus are autoimmune diseases

Front 18

Discoid lupus erythematosus (more of an organ specific autoimmune disease)

Back 18

# primarily appear as skin lesions around the cheeks and nose

Front 19

Which HLA molecules fall into MHC class I and II. What T cells promote function of those molecules

Back 19

# MHC class 1 : HLA A, B & C

# MHC class 2: HLA D

# MHC class 3: complement system

Class 1 functions by cytotoxic (CD8+) and Class 2 functions by Helper T cells (CD4+)

Front 20

Types of transplant rejection reaction

Back 20

# Hyperacute rejection

# Acute rejection

# Chronic rejection

Front 21

Explain the various transplant rejections. What type of molecules/cells mediate the occurrence of each of them

Back 21

Front 22

Does advanced maternal age increase the risk of mutation in offspring

Back 22

Yes, it does

Front 23

Types of genetic mutations

Back 23

1) Single gene/Mendelian mutation

2) Multiple gene/Polygenic/Multifactorial mutation

3) Chromosomal mutation (addition of or removal of a whole chromosome)

4) Mitochondrial DNA mutation

Front 24

What causes Duchenne muscular dystrophy

Back 24

Dystrophin

Front 25

Glomerular diseases are more common than hypertension and diabetes. T/F

Back 25

False

Front 26

Epidemiology of Glomerular diseases

Back 26

Front 27

Glomerulus, mesangium, basement membrane, podocytes image

Back 27

Front 28

Methods the glomerular cells respond to injury

Back 28

P. I. P

1) Phagocytosis (by mesangial cells)

2) Proliferation

3) Irreversible cell damage + fibrosis

Front 29

Do immune complexes always cause diseases?

Back 29

No they don't always

Front 30

The glomerular Filtration barrier has how many layers of negative charge. What are they?

Back 30

# 2 layers

# Glomerular endothelium and the Basement membrane

Front 31

The glomerular Filtration barrier has how many layers of negative charge. What are they?

Back 31

# 2 layers

# Glomerular endothelium and the Basement membrane

Front 32

Glomerular disease that cause nephritic syndrome

Back 32

# Circulating immune complex glomerulonephritis (eg post strep glomerulonephritis, SLE)

# Anti-GBM glomerulonephritis (rapidly progressive glomerulonephritis)

# Alport syndrome (mutation in collagen of GBM)

Front 33

Glomerular disease that cause nephrotic syndrome

Back 33

# In-situ immune complex glomerulonephritis

# NPHS 1 & 2 gene mutation

Front 34

The effect or appearance of the glomerulus / basement membrane in conditions of nephritis syndrome is

Back 34

# Swiss cheese appearance or Sieve effect

Front 35

What is goodpasture syndrome

Back 35

# AKA Anti-GBM glomerulonephritis

# It's an autoimmune disease & type 2 hypersensitivity condition

# Auto antibodies are directly against alpha-3 chain of type 4 collagen of basement membrane in KIDNEY & LUNGS

# This causes hematuria (nephritic syndrome) and rapidly progressive renal failure in kidneys; and hemoptysis and cough in lungs

Front 36

What factor is known to regulate C3 convertase? What is the name of the auto antibody that stabilize c3 convertase

Back 36

# H factor

# C3 nephritic factor (C3NF)

Front 37

Podocytes injury is classified into? Where are these injuries seen

Back 37

# Reversible (in immature podocytes)

# Irreversible injury with scarring (in mature podocytes cos they don't proliferate)

# Reversible injury is seen in Minimal Change Disease (which is in children cos their podocytes are immature and still developing)

# Irreversible injury is seen in Focal Segmental Glomerulosclerosis (FSGS) [in adults cos their podocytes are already developed and mature]

Front 38

Genetic causes of Glomerular diseases

Back 38

Front 39

Causes of Nephritic syndrome

Back 39

Front 40

Causes of Nephrotic syndrome

Back 40

Front 41

APOL 1 gene has been linked to non diabetic nephropathy. T/F

Back 41

True

Front 42

APOL 1 GENE

Back 42

Front 43

Define the terms Segmental, Focal, global, diffuse, membranous with respect to kidney

Back 43

Front 44

The commonest and 2nd commonest cause of lower GI bleeding in adults and children

Back 44

In adults

Commonest: Diverticulosis

2nd Commonest: Telangiectasia

In children/young people

Commonest: Hemorrhoids

Front 45

Commonest cause of upper GI bleeding is

Back 45

Peptic ulcer disease

Front 46

Classes of GI bleeding

Back 46

# Upper vs Lower GI bleeding

# Occult vs Overt

# Obscure vs Obvious

Front 47

Grading of finger clubbing

Back 47

Front 48

Mention the chest/thoracic contours

Back 48

# Barrel chest

# Pectus excavatum (funnel-shaped)

# Pectus carinatum

# Kyphosis

# Scoliosis

# Kyphoscoliosis

Front 49

Images of chest/thoracic contours

Back 49

Front 50

Conditions that deviate trachea and mediastinum to affected side

Back 50

# Pulmonary fibrosis

# Atelectasis

Front 51

Conditions that deviate trachea and mediastinum to unaffected side

Back 51

# Pnemothorax

# Pleural effusion

Front 52

Conditions that do not deviate trachea and mediastinum

Back 52

Consolidation

COPD

Front 53

What happens to fremitus on COPD

Back 53

Decreased fremitus

Front 54

Lung is hyper-resonant to percussion in what 2 cases

Back 54

# Pneumothorax

# COPD (hyperinflation)

Front 55

Which respiratory infections are more common; Upper or lower resp tract. What are they commonly caused by?

What bacteria is also known to cause URTIs? What % is attributed to the bacteria?

Back 55

# Upper respiratory tract infection (URTI)

# Viruses.

# Streptococcus pyogenes (15%)

Front 56

Spectrum of diseases in URTI

Back 56

# Rhinitis

# Sinusitis

# Rhinosinusitis

# Pharyngitis/Tonsillitis

# Laryngitis

# Tracheitis

Front 57

Presentation of URTI

Back 57

# Nasal discharge ; nasal congestion

# Sneezing

# Sore throat & cough

# Fever, malaise

# Loss of voice

# Headaches

Front 58

Guidelines for prescribing antibiotics for upper respiratory tract infection

Back 58

Depending on the severity, one of the 3 should be done

1) No prescribing (most URTI are of viral origin & will resolve spontaneously)

2) Delayed prescribing (if no recovery after giving patient time to recover)

3) Immediate prescribing

Front 59

Indications for immediate antibiotics prescription in URTI

Back 59

Front 60

Centor's criteria for strep pharyngitisl

Back 60

Front 61

Antibiotics used for URTI when indicated

Back 61

# Penicillin (amoxicillin, amoxicillin + clavulanate)

# 1st and 2nd generation cephalosporins

Note: Amoxicillin + clavulanate is called Augmentin

Front 62

Respiratory causes of finger clubbing

Back 62

# Suppurative lung disease (like bronchiectasis, lung abscesses, empyema)

# Pulmonary fibrosis

# Lung malignancy

# Complicated TB

# Mesothelioma

Front 63

Chest x ray findings in a patient with Pulmonary TB

Back 63

# Cavitation

# Pulmonary fibrosis

Front 64

Difference between erythema and petechaie/purpura

Back 64

# Erythema is blanchable (bcos it is due to vasodilation, pressure constrict the vessel back causing the skin to appear normal)

# Petechaie/purpura/ecchymoses are Non-blanchable