Schistosoma: Liver and spleen enlargement ( A shows S mansoni egg with lateral spine), fibrosis, inflammation, portal hypertension Chronic infection with S haematobium (egg with terminal spine B ) can lead to squamous cell carcinoma of the bladder (painless hematuria) and pulmonary hypertension Snails are intermediate host; cercariae penetrate skin of humans in contact with contaminated fresh water (eg, swimming or bathing). Tx: Praziquantel FA2021 160
PCOS: Hyperinsulinemia and/or insulin resistance hypothesized to alter hypothalamic hormonal feedback responseLH:FSH,androgens (eg, testosterone) from theca interna cells,rate of follicular maturationunruptured follicles (cysts) + anovulation. Common cause offertility in females. Enlarged, bilateral cystic ovaries A ; presents with amenorrhea/oligomenorrhea, hirsutism, acne, fertility. Associated with obesity, acanthosis nigricans.risk of endometrial cancer 2° to unopposed estrogen from repeated anovulatory cycles. Treatment: cycle regulation via weight reduction (peripheral estrone formation), OCPs (prevent endometrial hyperplasia due to unopposed estrogen); clomiphene (ovulation induction); spironolactone, finasteride, flutamide to treat hirsutism. FA2021 669
FFiSHH Pee in the C (sea) Ferritin Fibrinogen Serum Amyloid A Procalcitonin CRP
FA2021 page 214
Acute laryngotracheobronchitis also called croup. Caused by parainfluenza viruses. Virus membrane contains hemagglutinin (binds sialic acid and promotes viral entry) and neuraminidase (promotes progeny virion release) antigens. Results in a “seal-like” barking cough and inspiratory stridor. Narrowing of upper trachea and subglottis leads to characteristic steeple sign on x-ray. Severe croup can result in pulsus paradoxus 2° to upper airway obstruction. FA2020 page 170
Atrophy: in tissue mass due toin size (cytoskeleton degradation via ubiquitin-proteasome pathway and autophagy;protein synthesis) and/or number of cells (apoptosis). Causes include disuse, denervation, loss of blood supply, loss of hormonal stimulation, poor nutrition. FA2020 page 206
AD tubulointerstitial kidney disease: Also called medullary cystic kidney disease. Causes tubulointerstitial fibrosis and progressive renal insufficiency with inability to concentrate urine. Medullary cysts usually not visualized; smaller kidneys on ultrasound. Poor prognosis. FA2020 page 602
Heparin-induced thrombocytopenia (HIT) type 2—development of IgG antibodies against heparin-bound platelet factor 4 (PF4). Antibody-heparin-PF4 complex activates platelets thrombosis and thrombocytopenia. Highest risk with unfractionated heparin. HIT type 1 characterized by nonimmunologic milder drop in platelet count, usually asymptomatic. FA2020 page 436
Ureteropelvic junction (UPJ) obstruction is when part of the kidney is blocked. Most often it is blocked at the renal pelvis. This is where the kidney attaches to one of the ureters (the tubes that carry urine to the bladder). The blockage slows or stops the flow of urine out of the kidney. Urine can then build up and damage the kidney.
the Aldosterone was INCREASED in the answer
Hyperacute = minutes to hours, host preformed Ab against graft endothelial cell Ag = compliment activation, endothelial damage, inflammation (within the tissue, NOT interstitium), clotting cascade, ischemic necrosis and thrombosis. https://tpis.upmc.com/tpislibrary/kidney/KHAcuRej.html
Acute = weeks to months = graft Ag activates host CD4 and CD8 T cells leading to parenchymal cell damage, interstitial lymphocytic infiltration, and endotheliaitis. https://tpis.upmc.com/tpislibrary/kidney/KARejMod.html
Chronic = months to years, chronic DTH (type IV hypersensitivity) reaction in vessel wall leading to intimal smooth muscle cell proliferation and vessle occlusion, with biopsy showing narrowed vascular lumen and extensive smooth muscle.
GVHD = graft cells (most typically bone marrow transplants) recognize host cells as self/foreign and lead to destruction of host tissue leading to rash, jaundice, diarrhea, and GI hemorrhage (this occurs because most bone marrow transplant patients have undergone full radiation which attacks the rapidly providing cells most (i.e. skin, GI mucosa, hair, hepatocytes) so graft destruction of host cells in those areas leads to symptoms).
FFiSHH Pee in the C (sea) Ferritin Fibrinogen Serum Amyloid A Procalcitonin CRP
FA2021 page 214
Got this wrong, but when looking this up, I saw that SCID is associated with a lack of adenosine deaminase --> accumulation of adenosine, which is lympho-toxic.
The IMA comes off the aorta between the renal arteries and bifurcation. The IMA supplies the hindgut, which spans the distal 1/3 of transverse colon to upper portion of anal canal. Compromise of the IMA would lead to decreased blood supply to these structures, of which "Descending colon" is the only answer choice.
the Aldosterone was INCREASED in the answer
Heparin-induced thrombocytopenia (HIT) type 2—development of IgG antibodies against heparin-bound platelet factor 4 (PF4). Antibody-heparin-PF4 complex activates platelets thrombosis and thrombocytopenia. Highest risk with unfractionated heparin. HIT type 1 characterized by nonimmunologic milder drop in platelet count, usually asymptomatic. FA2020 page 436
acute interstitial nephritis
keys are: urine eosinophils + NSAID use + Rash
in the setting of fever and urinary issues
This patient has been taking HAART therapy and subsequently develops resistance mutations. The therapeutic purpose of HAART therapy is to target reverse transcriptase and protease enzymes. Since the patient is taking HAART therapy and subsequently developed viral resistance, we know the resistance has developed due to mutations in the genes that encode reverse transcriptase and protease.
Urethral injury: Occurs almost exclusively in males. Presents with blood at urethral meatus, hematuria, difficulty voiding. Urethral catheterization is relatively contraindicated. Anterior urethral injury—perineal straddle injury disruption of bulbar (spongy) urethra scrotal hematoma. If Buck fascia is torn, urine escapes into perineal space. Posterior urethral injury—pelvic fracture disruption at bulbomembranous junction, urine leakage into retropubic space and high-riding prostate. FA2021 page 651