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immunology Flashcards

1
Q

HIV early appearence

A

flue like prodrome

fever night sweats and weight loss

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2
Q

aids + CD4

A

CD4 <200 cells and or the presence of an opportunistic infection

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3
Q

AIDS labs

A

Elisa for initial screening is >99% sensitive

Western blot is confirmatory

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4
Q

AIDS absolute CD4 lymphocyte count

A

normal is >800

CD4 lymphocyte percentage to AIDS is high when <20%

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5
Q

AIDS viral load

A

should be zero, results correlate with progression of HIV

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6
Q

HIV PJC pneumonia propholaxysis

A

pneumocystis (pneumonia) jirovecii -leading cause of death in AIDS patinetns
Bactrium propholactally

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7
Q

Antiretrovetrial therapy

A

HAART
start at the time of HIV diagnosis
but not later than CD4 of 350

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8
Q

osteoarthritis

A

degenerative joint diseasease
weight bearing joints
swelling but NOT redness or heat
h

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9
Q

OA heberdines

A

distal interphalangeal joints DIPS where you hold the herb

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10
Q

OA Bouchards

A

Prohimal interphalangeal joints PIPS

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11
Q

OA pain

A

better in the morning gets worse over the day

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12
Q

OA x-ray findings

A

narrowng of the joint space
osteophytes
juxta articular sclerosis
subchondral bone

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13
Q

OA meds

A

ASA
Tylenol
Nsaids
Celebrex cox-2 inhibitor

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14
Q

OA supportive care

A 
weight loss
cane on opposite side
ICE to improve ROM
moist heat to decrease spasm and relieve stiffness
PT
refer for joint replacement
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15
Q

RA def

A

systemic autoimmune disease causing inflammation of the connective tissue

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16
Q

RA inflammation is

A

symetrical

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17
Q

RA age

A

35-50 yonger than OA

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18
Q

RA gender

A

women more than men 3-1

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19
Q

RA pain

A

worse in morning better as day goes on

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20
Q

RA labs

A

ESR usually elevated, ANA in 1/5 patients

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21
Q

RA diagnostics

A

synovial aspirate with inflammatory changes and WBC’s

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22
Q

RA x-ray

A

Joint swelling - OA is narrowing, cortical thinnin, osteopenia,

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23
Q

RA drugs

A 
high dose salicylates
nsaids
DMARDS
corticosteroids
methotrexate
antimalarials
gold salts injections
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24
Q

RA management

A

early rheum referral
rest
PT
surgery

25
Q

Orthor term avulsion

A

bone fragments pulled off by attached ligaments or tendons

26
Q

dislocation vs subluxation

A

disloction is disruption of normal relationship of bones, subluxation is incomplete discloction, dislocation is confirmed by x-ray

27
Q

methotrexate lab

A

watch LFTs

28
Q

Open fracture treatment

A

IV abx, sterile dressing, tetanus prophylazis and surgical debredment.

29
Q

Compartment syndrome

A

in the closed facial compartment, sever pain, skin profusion and arterial pulses are NORMAL, passive streth of the muscle is painful, repeated limb measurements are necessary

30
Q

lupus affects primarily

A

primarily wome of childbearing age
butterfly rash- affects 50% of paitntes but will be on test
ana will be +

31
Q

lupus management

A

bedrest
naps
avoid fatigue
sun protection

32
Q

drugs that make you look like lupus

A 
INH
methaldopa
qunidine
thorazine
hydralzine
procanimide
33
Q

giant cell arteritis

A

temperoal arteritis inflammtory condition primarily affeting patients ove the age of 50, can lead to permanaet blindenss. 50% of all cases fo fever of unknown origin over age 65

34
Q

giant cell arteritis

A 
fever 103-104 scalp pain
rigors and chills
nodular enlarded or tender
high esr and normal WBC 
temproal artery biopsy is positive in 85%
35
Q

giant cell areritis tx

A

referral and prednisone taper

36
Q

sinusitis most pronounced feature

A

post nasal drip

37
Q

optic disk

A

doughnut with orange/pink neurorential rim, and a central white depression

38
Q

cup disk ratio

A

cup should be no more than 1/2 the side of the disc diameter (if bigger consider glaucoma)

39
Q

eye arteries are brighter red and NARROWER than veins ratio is

A

2-3 or 4-5 A-V

40
Q

macula centered

A

2-2.5 disc dimeters temporal to the optic disc and is avascular

41
Q

Fovea centralis looks slightly darker and lies

A

in the center of the macular region, if macula is hard to see have the patient look directly into the light.

42
Q

common eye problems diabetic retinopathy

A

diabetic retinopathy- microanurysms are the earliest detectable sign, either superficial (flame shaped) or deeper (blot and dot) cotton wool spots

43
Q

eye problem asociated with chronic hypertension

A

AV nicking-

44
Q

arcus senilis

A

cloudy appearence of the cornea iwth a gray white arc or circle around the limbus due to deposition of the lipid material, has no effect on vision

45
Q

conjunctivitis

A

msot common eye disorder, inflammation/infection of the conjunctiva (pink eye) resulting from alergies, bacteria, virusis or std sti NO PAIN

46
Q

Conjunctivitis S and S Bacterial

A 
purulent discharge- self limiting, abx drops:
levofloxacin 
ofloxin
ciprofloxacin
tobramycin
gentamycin eye drops
47
Q

gonococcal or chlamydial conjunctivitis

A 
copious purulent drainage
gonoccal 
 ceftriaxone, 250 mg IM
chlamydia
erythromycin ointment
oral tetracycline, clarimycin, or doxy
48
Q

allergic conjunctivitis

A

stringy, increased tearing, oral antihistamines

49
Q

viral conjunctivitis

A

water dranage symptomatic

50
Q

corneal abriasion def

A

trauma to the epithelia surfac of the eye INTENSE PAIN

51
Q

corneal abrasion tx

A

sodium fluroesen stan detects abrasion
topical abx or sulfonamide drops
pressure patch for 24 hours
steroid drops are contraindicated and pain drops after exam cauuse u want to eval progress
should be heald in 24 hours if not refer.

52
Q

glaucoma

A

increased IOP
open angle is chronic
CLOSED ANGLE is emergence
10-20mmhg is normal

53
Q

glaucoma chronic

A

cupping of optic disc

constriction of visual fields

54
Q

glaucoma acute

A 
closed angle
extreme pain
blurred vision
halos around the lights
pupil fixed or dialated
55
Q

glaucoma test

A

tonometry- national screening by age 40

56
Q

management - glaucoma open

A

alpha 2 agonist- brimonidine, alhagan, beta adrenergic blocker- timolol

57
Q

management glaucoma closed

A

emergency
diamox- carbonic anyhydrase inhibitors
mannitol
surgery

58
Q

cataract def

A

cluding and opacificatoin of the normally clear lense of the eye
highest cause of treatable blindness
most common surgical procedure in 65+, senile cataracts

59
Q

cataract S and S

A 
painless
clouded or blurred vision, sensitivity to light iwth ellowing of colors
DOUBLE VISION IN A SINGLE EYE
no red light reflex
opacity of the lense

refer to opto for sx

issues and policy (22 decks)

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