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Classification of Vascular Lesions
Vascular malformations (flat lesions)
-Salmon patch (also known as nevus simplex or nevus telangiectaticus)
-Port-wine stain (also known as nevus flammeus)
Hemangiomas (raised lesions)
-Superficial hemangioma (also known as capillary nevus hemangioma)
-Deep hemangioma (also known as cavernous hemangioma)
Because they describe the lesion as cavernous vascular channels
After looking into it, port wine stain comes as part of Sturge Weber SYNDROME. Given that this child was coming in for a well-child examination, they're implying there's no other symptoms (SWS would have signs of other vascular malformations like in the CNS--> epilepsy).
I would say because this happened between two bacteria, but in transduction what causes the acquisition of bacterial resistance is coming from a bacteriophage, which is a virus that infects bacteria, but that is never hinted at the question!
Quick Overview of the involved topics and answer choices that are relevant in this question:
Transduction: Involves phage, cleaves DNA and takes a part with it as it is packaged. Generalized is when is happens by accident. Specialized is an excision event.
Transformation: bacteria takes up naked DNA around it and incorporates it therefore becoming "transformed" e.g. (SHiN) S. Pneuma, H. Influenza type B, and Neisseria.
Transposition: Jumping from one location to another within same bacterial organism (e.g. from chromosome to plasmid)
Conjugation: Above mentioned plasmid gets transferred from conjugal bridge from one bacteria to another.
Easy here...first both are G-ves which likely have a sex pilus and if cultured together as in this case transfer their plasmid. Transduction need phage. Transposition is exchange of genetic material inside the bacteria b/n the dna and the plasmid or vv (FA2019)
NBME does trick now and then.. when they zig you zag. then when you think they are going to zag, they zig just to destroy yourself confidence.
The abnormal T-cells are known as Downey type II cells (Sketchy)
I was recognized EBV, then knew EBV infects Bc, and the atypical lymphocytes are Tc. Then I said CD8 are MHC1 for virii, and bingo bango, boom.
Soooooooo EBV infested B- cells is not considered atypical WTFF??
They are atypical b/c usually you do not see a super high amount of CD8+ in peripheral blood. Now there are a ton to try to stop the infected cells.
oh and primary CNS lymphoma caused by EBV has T cells NOT B cells. I just try to remember the peripheral blood has atypical lymphocytes which are CD8+ T cells, and the CNS lymphoma is the opposite, ie; B cells
why not hep B? i guess another whats the better answer ones... Just rem reading that it was more common with aids pts.. anyone have an idea about this?
Yes, I think CNS lymphoma as an AIDS defining illness wins the day.
My thought was since SHE has AIDS it is most likely from IVDA, which has a high risk of HBV that could go undiagnosed for a long time. at 32, that might not be long enough to have HBV and get HCC (but with no immune system...?)
God damn this is such BULLSHIT...
My thought process, usually wrong all the time, was that HBV (IVDU) can occur to anyone. Acute hepatitis to Chronic occurs when HBV incorporates its DNA into host and releases mutagenic proteins. This is regardless of immunosuppresion. Primary CNS Lymphoma reappears primarily when you are immunosuppressed (organ transplant, immunodeficiency, HIV/AIDS).
Hep C is far more likely to become HCC than hep B
Even if you were thinking skin cancer is more common, that's only true for basal cell and squamous. Melanoma is rare. EBV much more likely in aids patient. Even H pylori was a better answer.
i get why its borderline now (I guess I kind of always thought suicide was the biggest part of that) but can someone tell me why its not paranoid? Is it just a matter of the "better" choice? The "youre the only one i can trust" thing lead me to that.
Paranoid is where they don't trust anyone or are weary of people. because she said she trusts only the physician can be a bit confusing, but she describes her coworkers as jerks, not that "oh they're out to kill me, they're government agents watching me"
Splitting association with borderline in FA 2020 pg 555 and 565
I picked impetigo because of the gold stippling... I guess I took that as honey crusted lesions. F*ck NBME.
Huffing gold spray paint. A la the chrome huffers in Mad Max
LOL I think that might be what they were going for here. Gold spray paint.
Anyone know what may be causing his weight loss and unwillingness to eat? I thought too much into it and put "mercury poisoning", since I thought the heavy metal's abdominal symptoms may have caused him to not want to eat. ¯_(ツ)_/¯
I'm not sure about the pathophysiology there... But I do know that inhalants are popular in places where there's extreme poverty. I spent some time abroad, and one of the patients was using inhalants to take the edge off the hunger, so that she could spend her money on food for her kids instead. She also worked on the streets so I guess it also made it easier to, you know...