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dr taher classes HK > CVS 11 > Flashcards

CVS 11 Flashcards

1
Q

types of inflammatory bowel disease HLA classification

A

Crohns and UC

HLA b27

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2
Q

other HLAB27

A

PAIR

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3
Q

which one of the IBD has granuloma formation

and which type of T helper response

A

Crohns

TH1

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4
Q

cytokines needed for granuloma

A

IL2 and IFN gamma

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5
Q

MHC classes and IBD

A

Crohns MHC I

UC MHCII

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6
Q

MHC I is present on which types of cells

A

all nucleated cells including platelets and virally infected cells EXCEPT RBC

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7
Q

MHCI antigen presentation

A

Endogenous pathway
large endogenous peptide is broken down to a proteosome—- transported to ER by TAP (molecular channel) —- loaded on the MHC I—- shuttled through golgi to the cell membrane

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8
Q

structure of MHC I and MHC II

A

MHCI —- heavy alpha 1 2 3 and small B2 globulin

MHC II — alpha 1 alpha 2 beta 1 beta 2 and INVARIANT chain

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9
Q

MHC II is present on

A

macrophages
dendritic cells
B lymphocytes

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10
Q

antigen processing of MHC II

A

EXOgenous
antigen is brought inside from extracellular site by phagocytosis (crush antigen) (phagolysosome)——- MHC II binds with phagolysosome —– the acidic ph in lysosome destroys the INVARIANT CHAIN—— free peptide binding groove exposed and antigen binds here

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11
Q

HLA A1

A

SLE

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12
Q

HLA A3

A

hemochromatosis

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13
Q

HLA B8

A

addison/ graves/ myasthenia gravis

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14
Q

HLA B27

A

PAIR

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15
Q

what does seronegative spondyloarthropathies mean?

A

negative for rheumatoid factor

which is igM against Fc of IgG

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16
Q

HLA C

A

psoriasis

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17
Q

HLA DQ2 DQ8

A

celiac disease

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18
Q

HLA DR2

A

multiple sclerosis/ SLE / hay fever/ Good pasture

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19
Q

HLA DR 3

A

Diabetes/ addison/ graves/ MGravis/ HASHIMOTO

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20
Q

HLA DR4

A

Diabetes/ addison

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21
Q

HLA DR5

A

HASHIMOTO/ RA/ Pernicious anemia

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22
Q

crohn disease mannifestation

A 
SISTER 
Skip lesions
Ileum affected m/c site
Sacharomyces cerevisae antibody
Transmural 
Extra fibrosis and FISTULA
Radiology string sign

Rectum is SPARED!!

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23
Q

Ulcerative colitis mannifestation

A 
Ulcers in mucosa submucosa (not muscularis)
Continuous retrograde
Originates rectum
Lead pipe
Increased cancer risk
Toxic megacolon
Increased growth from mucosa (pseudo polyps)
Severe symptoms
24
Q

types of fistulas in crohsn

A

entero enteric
entero vesicular
entero cutaneous (abd wall)
perianal

25
enterovesicular fistula characteristic finding
pneumoturia
26
other symptoms of crohns
fever fatigue cobble stone mucosa (wavy appearance) CREEPING fat --- mesenteric fat wraps around bowel) edematous and fibrosis of bowel (thickening)
27
other symptoms of crohns
EYE -- uveitis (iris, cilliary, choroid) MOUTH --- apthous ulcers JOINT --- arthritis RASH --- pyoderma gangrenosum, erythema nodosum INCREASE RISK OF CALCIUM OXALATE STONES
28
how does crohns increase risk of calcium oxalate stonse
normally calcium + oxalate ---- forms salts in gut and is excreted due to malabp calcium undergoes saponification with fat --- oxalate has no calcium to bind to --- it gets absp in the gut --- filtered to the kidney and forms calcium oxalate stones here
29
risk of calcium oxalate stones is also increased in?
increased ascorbic acid VIT C most stones are formed in acidic conditions except 1. calcium PHosPHate 2. ammonium mg PHosPHate
30
mnemonic for acidic vs alkaline stones
most stones form at low PH except 1. calcium PHosPHate 2. ammonium mg PHosPHate
31
blood bag has these components
Acid --- to shift O2 curve to right ... o2 unloading Citrate ----- binds calcium --- no coagulation Dextrose ---- RBC nutrition --- increases 2,3 BPG
32
radioopaque stones
almost all are radio opaque except radioLUcent | uric acid stones
33
shape of calcium oxalate stones
envelope/dumbells
34
shape of calcium phosphate stones
wedge shape
35
shape of uric acid stones
rhomboid rossettes
36
shape of ammonium magnesium phosphate stones
coffin lid
37
shape of cysteine stones
hexagonal
38
treatment of calcium phosphate stones
``` haydrate low sodium thiazide diuretics citrate remmber phosphate stones precipitate in alkaline media so giving citrate can help ```
39
who has risk of uric acid stones
``` lesch nyhan tumor lysis syndrome uricosuric drugs (probenacid, sulfinpyrazon) HIGH dose aspirin von gierke disease (hepatic glucose 6 psptase) thiazide niacin male diabetes HTN obesity alcohol red meat ```
40
what kind of crystals are seen in gout under polarized light
negatively birefringent crystals yeLLow when paraLLel light blue wen perpendicular light
41
tophus can be seen in
olecranon bursa external ear achiles tendon
42
pseudogout what kind of crystal?
calcium phosphate in the joint | Positive birefingent
43
risk factors for pseudogout
hemochromatosis trauma hyperpartahyroidism
44
what can be seen on imaging in pseudo gout
chondrocalcinosis | blue when parallel to light
45
what happens in tumor lysis syndrome
hyperkalemia postassium leaves damaged celsl hyperphosphatemia hyperuricemia due to nucleic acids broken down free calcium decrease (ca + phosphate) --- tetany
46
struvite staghorn calculus in adults and children
Adults ---- Ammonium magnesium phosphate | Children ---- cysteine
47
causes for ammonium magnesium phosphate stones
``` urease producing bacteria PUNCHKISS Proteus Ureaplasma urealyticum Nocardia Cryptococcus H pylori KI klebsiella S. epidermis ( NO sensitive) S. saprophyticus (NO resistant) ```
48
cysteine stones are linked to which condition
``` AR COLA Cysteine Ornithine Lysine Arginine ``` normally it is abspd in PCT
49
how to diagnose cystinuria
sodium cyanide nitropruside ---- turns blue
50
what can be seen on histology in crohns disease
paneth cells metaplasia | abcess ---- perforation ----- peritonitis
51
treatment for crohns
steroids azathioprine ( PRPP amidotransferase -) TNF alpha (infliximab / adalimumab) cipro/ metronidazole
52
does UC have granulomas?
NO
53
perinuclear anti neutrophil cytoplasmic antbodies seen in P ANCA
primary sclerosing cholangitis microscopic polyangitis churg straus
54
what can be seen in UC
haustras are lost toxic megacolon crypt abcess primary sclerosing cholangitis
55
treatment for ulcerative colitis
5 amino salicylic acid (mesalamine) 6mp/ azathioprine colectomy
56
sulfasalazine breaks down into
1. sulfapyridine (RA) | 2. 5 amino salicylic acid (UC)

dr taher classes HK (24 decks)

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