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THIRD YEAR > Repro 3 > Flashcards

Repro 3 Flashcards

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1
Q

HIV

A

retro virus transcribes its RNA using reverse transcription

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2
Q

normal CD4

OI CD4 count

A

500-1600

<200 but can get infections 200-500

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3
Q

HIV viral replication

A

rapid in very early and very late

new gen every 6-12 weeks

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4
Q

average time to death without treatment

A

9-11 years

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5
Q

infection

A

infection of mucosal CD4 (langerhan and dendritic cells) - regional LNs
infection established within 3 days

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6
Q

epidemiology of HIV

A

MSM

low SES

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7
Q

when do px present

A

2-4 weeks after infection

fever, maculopapular rash, myalgia, pharyngitis, headache/aseptic meningitis

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8
Q

pneumocystis pneumonia

A

CD <200
inside onset, SOB, dry cough, exercise desat

high dose co tramoxazole (+/- steroid)
proph for low CD4 low dose co -tramox

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9
Q

TB and immune reconstitution syndrome

A

immune system reactivated but is more aggressive

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10
Q

cerebral toxoplasmosis

A

CD4 <150
reactivation of latent virus
multiple cerebral abscess, chorioventinitis
headache fever decrease level of consciousness focal neurology seizures increased ICP

MRI ring enhancing lesions

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11
Q

cytomegalovirus

A

CMV
CD4<50
reactivation of latent virus - retinitis, colitis, oesophagitis
decreased visual acuity, floaters, abdominal pain, diarrhoea, PR bleeding

ophthalmic screening CD4<50

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12
Q

HIV assoc neurocognitive impairment

A

HIV1

reduce short term memory +/- motor dysf

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13
Q

progressive multifocal leukonencephalophathy

A

JC virus
cd4<100
rapidly progressive
focal neurology, confusion, personality change

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14
Q

haematological

A

anaemia thrombocytopenia

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15
Q

non opportunistic infection symptoms

A

mucosal candida, seborrheic derm, diarrhoea, fatigue, worsening psoriasis, LD, STIs, hep B, hep C

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16
Q

kaposkis sarcoma

A

HPV 8
more common in MSM
HAART, local therapies - systemic chemo

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17
Q

non hodgkins lymphoma

A

EBV

HIV and HAARTs

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18
Q

cervical cancer

A

HPV

women screened every year rather than every 3 years

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19
Q

risks of HIV transmission

A

concurrent STIs, anoreceptve sex, trauma, genital ulceration

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20
Q

types of HIV transmission

A

sexual
parental
maternal

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21
Q

risk of maternal tranmission

A

1-2%

<0.1% when viral load undetectable

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22
Q

what markers are used in HIV

A

viral rNA
antigen P24
antibody

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23
Q

3rd gen

A

ABs IgG/IgM

window period 20-25 days

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24
Q

4th gen

A

AB and AG P24

WP 14-28 days

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25
rapid hiv testing (POCT)
finger prick or saliva short wait. simple. good sensitive expensive. not suitable for high load
26
recent infection testing algorithm
can be used to measure if an infection has occurred within the preceding 4-6 months large margin of error
27
HAART drugs taken how
single tablet taking once daily tenofovir (NERTI) emtricitabine (NRTI) efavicrenz (NNTRI)
28
preventing drug resistance main thing
compliance
29
prevention of HIV
condoms rx STI screening and treatment post and pre exposure proph
30
hiv pos female and hiv neg male | hiv pos male and hiv neg female
insemination for baby | unprotected sex with HAART, inseminsation
31
prevention of maternal transmission
HAART during preg if viral load undetectable vaginal, if high CS 4 weeks PEP for neonate formula feeding
32
risk factors for breast cancer
``` age gene mutations BRCA1, BRCA2, TP53, PTEN, ATM, STKII/LKBI hyperplasia birth of first born after 30 alcohol early onset of periods FH early menarche low parity no BF late menopause endogenous or exogenous hormones BMI ```
33
what reduces the risk of BC
NSAIDs
34
BRCA1 | BRCA2
chromosome 17 | chromosome 13
35
pre meno | post meno
tamoxifen for 5 years | aromatase inhibitors such as letrozole, Anastrozole
36
beyond 5 years adjuvant therapy
5 years of tamox and now post meno then aromatase | if 5 years of tamox and still pre meno then more years of temox
37
HER2
tratsuzumab (herceptin) for a year
38
phyllodes tumrou
can be malignant cut surface looks like a leaf stromal and epithelial but stromal bit is neoplastic
39
angiosarcoma
post radiotherapy for breast cancer
40
atypical lobular hyperplasia | lobular carcinoma in situ
<50% of lobule involved | >50%
41
e cadherin gene
negative in lobular CDH1 gene deletion cell adhesion gene
42
pagets
high grade DCIS extending along ducts to epidermis of nipple still in situ cytokerin used to stain
43
micro invasive carcinoma
DCIS high grade | invasion of <1mm
44
ER positive
oophorectomy tamoxifen letrozole gosenlin
45
nottingham prognostico index adjuvant online PREDICT
histopatho histopatho + ER +CF histopatho + ER + CF + HER2 + mode of detection
46
triple assessment
clinical history and exam imaging - mam, USS, MRI pathology - cytopathology, histopatho, therapeutic
47
fibroadenoma
looks like phyllodes but phyllodes is in older women and are larger and increase in size
48
fibroadenoma
peak in 30s and repro life can grow rapidly if become pregnant african women
49
breast mouse
fibroadenoma
50
cysts
late repro life | FNA to dx and rx
51
tender before mentruation
cysts
52
papilloma
benign intracytic papillary prolif assoc with bloody cyst fluid
53
pagets disease
eczema like changes to nipple
54
adenolipoma
smooth palpable mass | characteristic mam pattern
55
apocrine metaplasia
of epithelial cells which enlarge and are eosinophillis | line cysts
56
glactocele
FNA to dx and treat
57
lipoma
palpable think smooth borders on mam adipose cells on biopsy
58
inflam of being just under chest wall
mordoms firm vertical cords and history of trauma resolves spontaneously in 8-12 weeks
59
gynacamastia
ductal growth but no lobular growth
60
fibrocystic change
40-50s | smooth discrete lumps, sudden pain of ruptured cyst, cyclic pain which changes with menstrual cycle, lump
61
haemartoma
circumscribed lesion composed of cell types normal to the breast but in abnormal proportion or distribution not troublesome - left alone
62
sclerosing lesions
benign disorderly proliferation of acini and stroma can cause mass of calcification may mimic cancer
63
sclerosising adenoma
pain or tenderness or lump/thickening often asymp benign
64
radial scar | complex sclerosing lesions
RA 1-9mm CSL >10mm mimic cancer cancer in situ/invasive can occur in the middle
65
stellate architecture
central puckering radiating fibrosis fibroelastic core epithelial prolif RS/CSL
66
duct ectasia
green/purulent/bloody dc | assoc with smoking
67
duct ectasia what is it
keratin plugging causes stasis of secretion - can lead to infection affects sub areolar ducts
68
how long does it take for the hcg to double
in 48 hours in early

THIRD YEAR (27 decks)

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