sbcp Flashcards by Leah McCoy

pseudostratified ciliated columnar epithelium

respiratory epithelium

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silver stain

pneumocystis carinii

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Pontiac fever

legionella pneumoniae

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pink puffer

emphysema

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blue bloater

chronic bronchitis

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alpha 1 antitrypsin deficiency

early onset emphysema and cirrhosis

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Charcot-Leden crystals
Curshmann spirals
Creda bodies

asthma

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acid and alcohol fast rods
ziehl-neelsen stain
ghon focus/complex
caseating granulomatous inflammation
epitheliod histiocytes
Longhand giant cells and lymphocytes

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Masson bodies

cryptogenic organising fibrosis

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crocidolite

nasty asbestos type

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Caplan lesions

coal workers pneumoconiosis

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erythema nodosum
granuloma
ACE
hypercalcaemia

sarcoidosis

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Kerley B lines
beads on a string (congested capillaries along alveolar septa)
heart failure cells (macrophages containing yellow brown haemosiderin granules)

pulmonary oedema

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smoker
older
nipple discharge

duct ectasia

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blood stained discharge

obstruction of single duct

intraductal papilloma (can become papillary carcinoma)

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clinical examination
mammography/USS
FNA/core biopsy

triple assessment

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exaggeration in normal physiological changes

fibroadenosis

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breast mouse

solid firm well circumscribed

fibroadenoma (phyllodes tumour - malignant counterpart)

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fibroblasts
histiocytes
adipocytes

fat necrosis

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lactating women

abscess

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eczema around nipple

pagets disease of the great (large round malignant epithelial cells invading squamous epithelium of nipple - underlying DCIS)

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calcification picked up on mammography

DCIS

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no necrosis or micro calcification
premenopausal
bilateral

lobular carcinoma in situ

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tubule formation

cells in nests/sheets/cords/islands

invasive ductal carcinoma (mucinous, tubular, medullary and papillary

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indian file

infiltrating lobular carcinoma

red infarct

venous occlusions lung dual circulation

pale infarct

solid organs with single blood supply eg heart, spleen, kidney

distal tissues - pale painful pulseless cold

arterial thrombus

distal tissues swollen red tender

venous thrombus

Charcot Bouchard brain aneurysm retinopathy papilloedema benign nephrosclerosis

hypertension

malignant arteriosclerosis fibrinoid necrosis of arterioles hyperplastic arteriolitis/onion skinning (concentric lamellae

malignant hypertension

Aschoff body (pale focus on eosinophilic hyaline material surrounded by lymphocytes and macrophages

rheumatic fever

squamous epithelium

ectocervix

mucin secreting glandular epithelium

endocervix

junction of endo and ectocervix

transformation zone | LLETZ - large loop excision of transformation zone

dysplasia of bottom 1/3 cervical epithelium

mild cervical intraepithelial neoplasia (CIN I)

dysplasia of bottom 2/3 cervical epithelium

moderate cervical intraepithelial neoplasia (CIN II)

full thickness dysplasia of cervical epithelium

severe cervical intraepithelial neoplasia (CIN III) | progresses to squamous carcinoma

koliocytosis | large and irregular nuclei

HPV infection

lots of mucin nuclei heaping on top of each other apoptotic bodies mitotic figures

cervical glandular intraepithelial neoplasia (CGIN) low/high grade progresses to adenocarcinoma

HPV 6 + 11

low risk cervical cancer | anal warts - condyloma accuminatum

HPV 16 + 18

high risk cervical cancer | anal intraepithelial neoplasia (AIN)

polypoid/friable mass arising in transformation zone | cells invading stroma

squamous cell carcinoma

endocervix | not visible at colposcopy

adenocarcinoma

squamous and adenocarcinoma components

adenosquamous carcinoma

keratinising stratified squamous epithelium

normal vulva

white itchy vulval dystrophy

lichen sclerosis

squamous cell hyperplasia

vulval dystrophy

younger patient HPV link multifocal low invasion risk

bowenoid/undifferentiated vulval intraepithelial neoplasia (VIN I-III) preinvasive progress to vulval squamous carcinoma

``` older patient no HPV link associated dystrophies unifocal high invasion risk ```

simplex/differentiated vulval intraepithelial neoplasia (VIN I-III) preinvasive progress to vulval squamous carcinoma

intraepithelial adenocarcinoma

pagets disease

circumscribed tumour white whorled cut surface spindle shaped cells lack atypical features

fibroids/leiomyoma

endometrial tissue in myometrium

adenomyosis

endometrial tissue in site distant from uterus

endometriosis | small risk of malignant change

precursor - endometrial hyperplasia perimenopausal high BMI, HTN, DM unopposed oestrogens

type 1 endometrial cancer - endometrioid type adenocarcinoma

``` older patient without normal risk factors atrophic endometrium aggressive advanced stage and poor prognosis p53 mutation infiltrates myometrium hobnail appearance papillary structures ```

type 2 endometrial cancer - serous carcinoma

spindle shaped cells nuclear pleomorphism areas of necrosis

leiomyosarcoma (malignant counterpart to fibroid)

small blue cells invading myometrium very bland few mitotic figures

endometrial stroma sarcoma

adenocarcinoma and sarcomatous elements

carcinosarcoma/malignant mixed mullein tumour (MMMT)

multiple cysts | follicular derivation

PCOS

mucinous cystadenoma

benign

thin walled cyst with some papillary growths

borderline

solid or complicated cystic

malignant - subtypes; mucinous, serous, endometrioid, clear cell, transitional

risk of malignancy index

menopausal status CA125 level USS findings

mature teratoma (dermoid cyst) with skin appendages, hair, gut etc

benign germ cell tumour

``` immature teratoma teratoma with malignant transformation yolk sac tumour (check serum AFP) dysgerminoma choriocarcinoma (check serum hCG) ```

malignant germ cell tumours

fibroma/fibrothecoma | ascites and plural effusions

benign sex cord stromal tumour | Mengs syndrome

granulosa cell tumour | nuclear grooves

malignant sex cord stromal tumours

large multinucleated cells

osteoclasts

mononuclear cells on bone surface

osteoblasts

osteoblasts surrounded by osteoid

osteocytes

``` haematoma and acute inflammation organisation of haematoma (granulation tissue) primary callus response external bridging callus remodelling several months later ```

fracture healing

``` staph aureus e coli pneumococcus group a strep mycobacterium tuberculosis ```

organisms of osteomyelitis

fibrous stroma containing plasma cells and lymphocytes

chronic osteomyelitis

synovial hyperplasia chronic inflammation lymphoid aggregates lymphoid follicles

rheumatoid arthritis

fixed hyper extension of PIP and flexion of DIP

swan neck deformity

fixed hyper flexion of PIP and extension of DIP

boutonnieres deformity

``` reduced amount of normally mineralised bone loss of microarchitecture thinning of cortical bone trabecular bone poorly defined no interconnections ```

osteoporosis

increased seams of unmineralised osteoid

osteomalacia

bone thickened increased osteoblasts disorganised

pagets disease

long bones central nidus of irregular trabecular / woven bone and osteoid in highly vascular stroma surrounded by mass o sclerotic bone

osteoid osteoma - benign

cartilage capped bony projection

osteochondroma - benign

cartilaginous lesion in medullary cavity

enchondroma - benign | hard to tell apart from a low grade chondroscarcoma - malignant

locally aggressive in epiphysis may produce osteoid

giant cell tumour - benign

produces malignant osteoid intramedullary high grade

osteogenic sarcoma - malignant

small round blue cell tumour poorly differentiated affects shaft of long bones

ewings sarcoma - malignant

``` thyroid breast prostate lung kidney ```

common primary sites of bone metastases

follicles and germinal centres B cells (macrophages between follicles)

lymph node cortex

lymph sinuses (containing macrophages) blood vessels some b cells

lymph node medulla

T cells

lymph node paracortex

granulomatous inflammation

``` sarcoidosis TB fungal infection hodgkins crohns ```

non caseating granulomata eptheloid cells langhans giant cells and lymphocytes increased calcium and ACE

sarcoidosis

indolent - lymphocytic / follicular aggressive - lymphoblastic, burrkits, diffuse large B cell, mantle cell 85% B cell

Non Hodgkins Lymphoma

small lymphocytes prolymphocytes most common leukaemia

chronic lymphocytic leukaemia (CLL) | NHL

centroblasts and centrocytes

``` follicular lymphoma (NHL) progresses to diffuse large B cell lymphoma (NHL) ```

``` lymphatoid polyposis (extra nodal in small bowel) monotonous proliferation of small lymphoid cells ```

mantle cell (NHL)

jaw / ileocaecal mass intermediate cells starry sky appearance diffuse growth

burrkits (NHL)

worse than b cell cell size varies sezary syndrome - spreads to blood mycosis fungicides - primary cutaneous

T cell lymphoma (NHL)

Reed Sternberg cells

Hodgkins lymphoma (HL)

nodular sclerosis - lacunar cells and sclerotic bands | mixed cellularity - Reed Sternberg!

classical Hodgkins lymphoma

Philadelphia chromosome

chronic myeloid leukaemia (CML)

blast seen merges with lymph node disease children

acute lymphoblastic leukaemia

plasma cell neoplasm bence jones protein in urine monoclonal Ab band on plasma electrophoresis

myeloma

stratified squamous to columnar epithelium premalignant red on endoscopy

barretts metaplasia of oesophagus

periodic acid schiff (PAS) positive hyphae stained red white plaques on endoscopy

candida

linear punched out ulcers | multinucleated giant cells with ground glass inclusions

hERPES

exophytic polypoid luminal mass / necrotising malignant ulcer eroding wall / adjacent structure diffuse infiltrating neoplasm causing stricture

squamous carcinoma of oesophagus | most common type

oesophageal cancer obese middle aged white men barretts risk factor

adenocarcinoma

petechial/flea bitten haemorrhage in stomach mucosa

acute / erosive gastritis

autoimmune lymphocytic pernicious anaemia

type a chronic gastritis

h pylori infection

type b chronic active gastritis

mucosal injury and regenerative change eg reflux, drugs, chemicals

type c chronic gastritis

defect in epithelial lining where it undergoes necrosis due to direct toxic insult and inflammatory response

peptic ulcer

gland forming tumour in body/antrum/cardia

intestinal type gastric carcinoma

infiltrate of mucin containing signet ring cells extensive invasion stomach walls 'linitis plastic' early age e cadherin gene mutation

diffuse type gastric carcinoma

confined to mucosa / submucosa without involving muscularis propria

early gastric carcinoma

bilateral ovarian tumours

krunkenberg

left supraclavicular node

virchows node - gastric carcinoma

long-standing h pylori infection | antigen dependent polyclonal lymphoid proliferation

gastric lymphoma | low grade

antigen dependent monoclonal neoplastic lymphoid proliferation

MALToma / marginal zone lymphoma | high grade if antigen INdependent monoclonal malignant growth

mesenchymal spindle cell tumour c-kit/CD117 expression treat with Gilvec (tyrosine kinase inhibitor

GI stromal tumour (GIST)

uncommon tumour jejunum napkin ring structure complication of coeliac or crohns

adenocarcinoma

neuroendocrine produce serotonin / 5-HT, 5-HIAA, and vasoactive fibrogenic factors liver mets leading to carcinoid syndrome insular/trabecular pattern

carcinoid tumour

tumour in duodenum | Zollinger Ellison syndrome

gastrin cell tumour

high grade and aggressive lymphoma

enteropathy associated T cell lymphoma other lymphomas include post transplant lymphoproliferative disorder, MALToma, Burkitts, mantle cell (polyps)

common hyperplastic/metaplastic little malignant potential adenomatous - tubular/villous/tubulovillous

polyps

autosomal dominant mutation in APC gene hundreds of adenomatous polyps prophylactic panproctocolectomy

familial adenomatous polyposis (FAP)

micro satellite unstable pathway | mutation in DNA repair genes

hereditary non polyposis colon cancer (HNPCC) - Lynch syndrome

micro satellite unstable pathway | mutation in DNA repair genes

hereditary non polyposis colon cancer (HNPCC) - Lynch syndrome

psuedomyoma peritonei | mucinous ovarian tumours

mucocele of appendix

aggressive | conventional carcinoid with insular/nested growth pattern or goblet cell/crypt cell carcinoid (mucin secreting cells)

carcinoid of appendix

anal canal carcinoma (basaloid/keratinisng squamous cell carcinoma) malignant melanoma pagets disease

anal cancers

H pylori infection in duodenum

duodenitis

``` gluten intolerance anti gliadin (AGA) anti endomysial (EMA) anti transglutaminase (TGA) villous atrophy crypt hyperplasia ```

coeliac disease

tropheryma whippeli | PAS positive macrophages

whipples disease - gastroenteritis

remnant of vitello intestinal duct

meckels diverticulum

``` granular mucosa crypt abscesses and destruction chronic inflammation polyps goblet cell depletion ulceration ```

ulcerative colitis

cobblestone/ulcerated mucosa aphthous/fissuring ulceration focal ulceration and transmural lymphoid aggregates and granuloma skip lesions

crohns disease

portal vein hepatic artery bile duct

portal triad

anatomical division hexagonal central vein at centre portal tracts at periphery

lobule

functional division central axial vessels central veins at periphery zones 1-3

acinus

increased AST and ALT

hepatic picture

increased ALP and GGT | increased bilirubin

cholestatic picture

bilirubin >35 mol/L

VISIBLE jaundice

fatty change and feathery degeneration

reversible acute liver injury

necrosis apoptotic bodies - spotty necrosis confluent necrosis

irreversible liver damage

``` autoimmune anti mitochondrial antibodies (AMA) portal tract lymphocytic infiltrate ductopenia granulomas ```

primary sclerosing cholangitis

ssRNA enterovirus faecal oral spread no carrier state / chronic infection

hepatitis a

``` dsDNA hepadnavirus parenteral eg iv drugs, sex, blood acute - hepatitis and recovery asymptomatic carrier phase chronic - hepatitis and cirrhosis / hepatocellular carcinoma ```

hepatitis b

ssRNA flavivirus parenteral transmission carrier state and risk of chronic

hepatitis c

diffuse irreversible disruption of entire liver architecture structurally abnormal regenerative nodules separated by interconnecting bridging bands of fibrous tissue collagenous tissue scattered lymphocytes proliferation of bile ductules

cirrhosis | small shrunken liver with nodular surface

steatohepatitis - steatosis, hepatocyte balloon swelling, Mallory's hyaline (eosinophillic extracytoplasmic globules - tangles of filaments)

alcoholic liver disease

autosomal recessive HFE gene mutation - C282Y excessive iron absorption in small intestine Perls Prussian blue iron stain - blue granules of haemosiderin in hepatocytes

haemochromatosis

autosomal recessive mutation in copper transporting ATPase | kayser fleischer rings in eyes - peripheral iris brown

Wilsons disease

rounded eosinophilic lobules within hepatocytes

alpha 1 antitrypsin globules

acinar cell injury necrosis inflammation

acute pancreatitis

inspissation of secretions ductal plugs loss of pancreatic parenchyma and fibrosis dystrophic calcification

chronic pancreatitis

insulinoma - hypos gastronoma - Zollinger Ellison MEN-1 - pit and parathyroid tumours

pancreatic endocrine neoplasms (PENs)

dendritic antigen presenting cells

langerhans cells

``` spongiosis inflammatory infiltrate in dermis lymphocytes in epidermis parakeratosis pomphylx - intraepithelial water accumulation forming vesicles ```

eczema

parakeratosis neutrophil polymorphs (munro micro abscesses) thickening and elongation of epithelial rete processes no granulomas

psoriasis

sawtooth rete processes lymphohistiocytic infiltrate basal cell liquefaction degeneration colloid/civatte bodies (apoptotic keratinocytes)

cutaneous lichen planus

relatively uniform basaloid cells cell islands surrounded by palisade hair follicle differentiation

basal cell carcinoma

squamous cell carcinoma in situ

Bowens disease

S100 protein HMB45 Melan A

stains for malignant melanoma

malignant melanoma in situ

Hutchinson's melanotic freckle / lentigo maligna

flattening of calyces renal parenchymal thinning cystic thin walled fibrous sac

hydronephrosis

polar scar involving calyx | thyroidisation of tubules -dilation with pink material resembling thyroid colloid

chronic pyelonephritis

bilateral renal agenesis leading to oligohydramnios reduced room for foetus characteristic facial features and posture pulmonary hyperplasia not compatible with life

potters syndrome

PKD 1

autosomal dominant | chromosome 16

PKD 2

autosomal dominant | chromosome 4

Childhood PKD

autosomal recessive | chromosome 6

calcium oxalate / phosphate | radio opaque

renal calculi

firm well demarcated white nodule in medulla

fibroma/harmartoma | benign renal neoplasm

from renal tubular epithelium | low malignant potential

cortical adenoma | benign renal neoplasm

from distal tubule enlarged cells granular esoinophillic cytoplasm

oncocytoma | benign renal neoplasm

medulla/cortex | blood vessels, smooth muscle, and fat

angiomyolipoma | benign renal neoplasm

``` most common 3p deletion polyhedral cells with abundant clear cytoplasm vacuolated cytoplasm pyknotic nuclei ```

clear cell carcinoma | malignant renal neoplasm

``` trisomy 7 and 17 papillary structures esoinophillic cytoplasm friable often bilateral ```

papillary carcinoma | malignant renal neoplasm

``` large cells well defined - good prognosis granular cytoplasm thick cell membrane perinuclear halo ```

chromophobe carcinoma | malignant renal neoplasm

children <4 yrs large solid mass of firm white tissue small round blue cell tumour

``` Wilms tumour (nephroblastoma) malignant renal neoplasm ```

rare autosomal dominant condition | chromosome 3

von hippel lindau disease

``` non proliferative glomerulonephritis proteinuria hypoalbuminaemia oedema hyperlipidaemia ```

nephrotic syndrome

``` proliferative glomerulonephritis oliguria hypertension haematuria mild oedema mild proteinuria ```

nephritic syndrome

aniline dyes analgesic misuse early haematuria and obstruction

transitional cell carcinoma

full thickness cytological atypic confined to epithelium loss of umbrella cells red patches treat with BCG therapy

TCC in situ

warty / cauliflower like papillomatous projections from mucosa

papillary TCC

``` schistosomiasis areas of squamous metaplasia solid ulcerative fun gating mass poor prognosis TURBT and BCG therapy ```

squamous carcinoma of bladder

urachal remand | transitional epithelium metaplasia

adenocarcinoma of bladder

bowenoid papulosis (HPV) erythroplasia de queyrat (CIS of glans/foreskin) Bowens disease

pre neoplastic penile conditions

squamous cell carcinoma spindle cell carcinoma adenosquamous carcinoma malignant melanoma

malignant penile tumours

fluid in tunic vaginalis (patent)

primary hydrocele

well defined unilateral large cells with clear cytoplasm aggregates separated by fibrovascular lymphoid stroma

seminoma | germ cell tumour of teste

leydig/sertoli cell tumours | almost always benign

sex cord stromal tumours

increased glandular and stromal elements | glands still in lobules

benign prostatic hypertrophy

AFP secreting germ cell tumours note all germ cell tumours can produce hCG by syncytiotrophblasts

embryonal carcinoma yolk sac tumour teratoma NOT seminoma choriocarcinoma

oligodendrocytes

form myelin

ependymal cells

line ventricular system

increased CSF

hydrocephalus

>15 mgHg spatial compensation (older patients better bc brain atrophy) cerebral percussion falls

increased ICP

increased bp to maintain perfusion (widened pulse pressure) | bradycardia

cushings response

CN III palsy PCA compression midbrain and pons haemorrhage

uncal herniation coning = tonsillar herniation

gross - no change | microscopic - red neurons and oedema

0-6 hrs post stroke

gross - pale swollen loss of grey/white matter margin microscopic - neutrophil polymorphs

onset to 48hrs post stroke

gross - gelatinous and friable microscopic - nil

2-10 days post stroke

gross - liquefying necrosis leaving cavity microscopic - macrophages

10 days - 3 weeks post stroke

no gross or microscopic changes

first 24 hrs post MI

pale with inflammatory reaction at edges | loss of striations

>24 hrs post MI

macrophages (removing dead myocytes) | healing by repair, reorganisation, and progressive fibrosis - scar tissue

days - weeks post MI

akinetic mature fibrous scar no contraction may be weak

months post MI

venous bleed

subdural

middle meningeal artery bleed

extradural

grade IV | poorly defined

astrocytoma

more sharply defined | calcification

oligodendrocytoma

``` meningeal gliomatosis (CSF dissemination) children ```

ependymoma

benign neurofibromatosis type 2 oestrogen drive increases size associated with breast and endometrial cancer

meningioma

breast lung GIT

common primary sites of brain metastases

e coli group b strep listeria monocytogenes

neonatal meningitis

h influenzae

meningitis in children

neisseria meningitides

adolescent meningitis

strep pneumoniae | listeria monocytogenes

meningitis in elderly

swollen brain with flattened gyral pattern, thick purulent exudate on base of brain, brainstem, and cerebellum neutrophils and necrotic debris

meningitis

cloudy / turbid increased protein and neutrophils decreased glucose

bacterial meningitis

clear / turbid mild increased protein increased lymphocytes normal glucose

viral meningitis

large necrotic brain abscesses

toxoplasmosis (HIV)

global atrophy neuritic plaques amyloid angiopathy (beta A4 stained with silver/congo red and apple green under polarised light) Tau2 positive neurofibrillary tangles

Alzheimers

pick cells | neuronal swelling

picks disease

spongiosis / vacuoles in grey matter

CJD

``` substantia nigra involvement (pallor) decreased dopamine Lewy bodies (intracytoplasmic inclusions formed by protein deposition) ```

Parkinsons

``` autosomal dominant CAG repeat sequence short arm chromosome 4 cerebral atrophy loss of striatal neurons reactive astrocytosis ```

Huntingtons

``` myelin sheath destruction plaque formation perivascular invasion macrohage action decreased oligodendrocytes ```

petechial haemorrhage of axillary bodies | alcohol associated

wernickes disease

alpha - glucagon beta - insulin gamma - pancreatic polypeptide omega - somatosatin

produce of pancreas islet cells

insulin deficiency autoimmune destruction of beta cells HLA DR3/4 haplotype

type 1 DM

insulin insensitivity | obesity - adiponectin levels

type 2 DM

elevated blood lipids reduced HDL increased thromboxane A2 hyaline atherosclerosis

accelerated atherosclerosis

nodular glomerulosclerosis in DM

kimmelstein wilson lesion

``` masses of lymphoid tissue lymphocytes germinal follicles eosinophilic pink appearance autoimmune ashkenazi / hurtle cell change ```

hashimotos thyroiditis

hyper functional diffuse thyroid enlargement infiltrative opthalmopathy auto anti TSH receptor antibodies TSH binding Ig

Graves disease

papillary structure central fibrovacular core covered by columnar epithelium orphan Annie eyes

papillary thyroid carcinoma

worse prognosis functional nodules invasion of fibrous capsule

follicular thyroid carcinoma

``` neuroendocrine from parafollicular/c cells secrete calcitonin amyloid stroma MEN and paraneoplastic syndromes ```

medullary thyroid carcinoma

poorly differentiated poor prognosis spindly tumour cells no follicle formation

anaplastic thyroid carcinoma

B cell low grade complicating thyroiditis

thyroid lymphoma - rare

``` liver mets/hepatomegaly elevated serotonin and 5-HIAA facial flushing apparent cyanosis gi upset cough/wheeze/sob systemic fibrosis ```

carcinoid syndrome

catecholamine producing tumour of adrenaline medulla (chromaffin cells)

pheochromocytoma

parathyroid hyperplasia/adenoma pancreas endocrine tumour pituitary prolactinoma chromosome 11 TSG gene mutation

MEN 1

medullary thyroid carcinoma pheochromocytoma parathyroid hyperplasia autosomal dominant mutation in RET proto oncogene on chromosome 10

MEN 2A

same as 2A minus hyperparathyroidism plus mucosal neuromas ad marfanoid appearance RET proto oncogene mutation

MEN 2B

neutrophil polymorphs | small studded abscesses through renal parenchyma

acute pyelonephritis

bad prognosis aggressive gland forming renal medulla

collecting duct carcinoma | malignant renal neoplasm

renal cancer grading system

Fuhrman | based on nuclear size

lymphoma staging

Ann Arbor

autoimmune bile duct destruction elevated ALP elevated cholesterol AMA positive

primary biliary cirrhosis / cholangitis

chronic inflammation of hepatic bile ducts associated with ulcerative colitis MRCP diagnosis ‘beading’ periductal onion skinning fibrosis pattern

primary sclerosing cholangitis

``` non caseating granuloma epithelioid cells langhans giant cells lymphocytes asteroid / schaumann bodies raised calcium and ACE ```

sarcoidosis

young women neck lymph nodes lacunar cells sclerotic bands excellent prognosis

classical Hodgkin’s lymphoma - nodular sclerosis

intra epidermal blistering of skin and mucous membranes | anti desmosome antibodies

pemphigus vulgaris

sub epidermal blisters of skin | anti basement membrane antibodies

bullous pemphigoid

lamivudine

hep b suppression

interferon

hep b cure of high grade infection

interferon and ribavirin

cure high grade hep c infection

nucleoside reverse transcriptase inhibitor non nucleotide reverse transcriptase inhibitors protease inhibitors

anti retro viral triple therapy

gram positive sporing anaerobic rod

C. Diff

c diff treatment

mild - metronidazole severe - vancomycin refractory - colectomy

gram neg anaerobic rod | undercooked meat

salmonella | antibiotics only if immunocomp.

gram neg anaerobic rod | contaminated food / water

E. coli Fluids and electrolytes Cephalosporins, quinolones, doxycycline

gram neg spiral bacteria

h pylori | triple therapy with ranitidine, tetracycline, and clarithromycin

vomiting and watery diarrhoea

norovirus anti motility and emetics IV fluids

yeast like fungus

pneumocystis jirovecii trimethoprim- sulfamethoxazole resp support

double stranded dna herpes virus

CMV | HAART

invasive budding yeast

Candida albicans Oral / topical nystatin Oral fluconazole

gram positive coccus

Staph aureus - fluclox MSSA - methicillin MRSA - vancomycin / teicoplanin

impetigo (staph aureus / strep pyogenes infection of epidermis)

topical Abx Penicillin Trimethoprim- MRSA

infection of dermis and subcut fat

cellulitis Flucloxacillin Cephalosporin Vancomycin

necrotising fasciitis

IV carbapenem, beta lactamase inhibitor, vancomycin, clindamycin Surgical debridement

encephalitis

viruses - aciclovir | listeria monocytogenes, mycobacteria - empirical then target

brain abscess

staph aureus streptococcus enterobacteriacae pseudonymas aeruginosa

CAP

strep pneumoniae - amoxicillin

day 1-2 CAP

congestion - alveoli fill with fluid

day 3-4 CAP

red hepatisation - exudate (rbcs and fibrin) fill airspace

Day 5-7 CAP

grey hepatisation - rbcs break down and become grey

mycobacterium tuberculosis

prophylactic - bcg vaccine latent - 9 months isoniazid active - isoniazid, rifampicin, pyrazinamide, ethambutol for 2 months

penicillin

inhibitor of bacterial penicillin binding protein preventing cross linking of peptide chains in cell wall ``` resp infections UTI otitis media bacterial meningitis - benzoyl penicillin severe infection - piperacillin ```

cephalosporins (cef-)

inhibitor of bacterial penicillin binding protein preventing cross linking of peptide chains in cell wall meningitis sepsis pneumonia

carbapenems

inhibitor of bacterial penicillin binding protein preventing cross linking of peptide chains in cell wall pseudomonas aeruginosa pneumonia intra abdo complicated UTI

tetracycline

bind to 30s bacterial ribosomal subunit inhibiting RNA formation - bacterial protein synthesis chlamydia mixed RTI acne vulgaris pneumonia

aminoglycosides (gentamicin)

bind to 30s subunit inducing mRNA misreading stopping polypeptide forming - cell death ``` AEROBIC ONLY meningitis sepis pyelonephritis endocarditis pseudomonas aeruginosa ```

macrolides (-mycin)

binds 50s subunit stopping tRNA transfer stopping polypeptide elongation ``` LRTIs cellulitis acne h pylori chlamydia ```

vancomycin

binds to terminal chains of NAMA and NAG blocking polypeptide elongation - no cell wall - cell death endocarditis MRSA c diff

trimethoprim

inhibits bacterial dihydrofolate reductase stopping bacterial DNA synthesis uncomplicated UTI pneumocystis carinii

amphotericin

binds ergosterol in fungal cell membrane forming pore - leakage - death systemic fungal infection candidiasis

fluconazole

inhibits fungal cytochrome P450 3A depleting ergosterol altering membrane fluidity and preventing mitosis candidiasis fungal infection in immunocomp. derm fungal infection systemic fungal infection

aciclovir

competitively inhibits viral DNA polymerase - nuclear chain terminator - preventing viral DNA replication herpes simplex varicella zoster

sbcp Flashcards

(294 cards)