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Pathology
kayser fleischer rings
Submitted by Dr.bisho on Wed, 02/06/2010 - 7:45pm.
Kayser-Fleischer rings (KF rings) are dark rings that appear to encircle the iris of the eye. They are due to copper deposition as a result of particular liver diseases. They are named after Dr Bernhard Kayser and Dr Bruno Fleischer, the German doctors who first described them in 1902 and 1903. Initially thought to be due to the accumulation of silver, they were first demonstrated to contain copper in 1934.
The rings, which consist of copper deposits where the cornea meets the sclera, in Descemet's membrane, first appear as a crescent at the top of the cornea. Eventually, a second crescent forms below, at 6 o'clock, and ultimately completely encircles the cornea.
Associations
Kayser-Fleischer rings are a sign of Wilson's disease, which involves abnormal copper handling by the liver resulting in copper accumulation in the body and is characterised by abnormalities of the basal ganglia of the brain, liver cirrhosis, splenomegaly, involuntary movements, muscle rigidity, psychiatric disturbances, dystonia and dysphagia. The combination of neurological symptoms, a low blood ceruloplasmin level and KF rings is diagnostic of Wilson's disease.
Other causes of KF rings are cholestasis (obstruction of the bile ducts), primary biliary cirrhosis and "cryptogenic" cirrhosis (cirrhosis in which no cause can be identified).
OSPE REVIEW 2006 BATCH (3-6)
Submitted by admin on Tue, 25/05/2010 - 11:17pm.
There will be an OSPE review on the 3rd of June 2010.
Details of the exact timing and content will be later attached here, and can be also seen available as an email that will be sent over to you by the end of this week.
Thank you
Good luck in your studies
- 1 comment
- 232 reads
Gestational Diabetes
Submitted by M.R.T. on Mon, 15/02/2010 - 12:49am.
Definition
Gestational diabetes(GDM) is defined as glucose intolerance of variable degree with onset or first recognition during the present pregnancy. It can be screened by drawing a 1-hour glucose level following a 50-g glucose load, but is definitively diagnosed only by an abnormal 3-hour OGTT following a 100-g glucose load.
Importance
The growth and maturation of the fetus are closely associated with the delivery of maternal nutrients, particularly glucose. This is most crucial in the third trimester and is directly related to the duration and degree of maternal glucose elevation. Thus, the negative impact is as highly diverse as the variety of carbohydrate intolerance that women bring to pregnancy.
For the mother with GDM there is a higher risk of hypertension, preeclampsia, urinary tract infections, cesarean section, and future diabetes. Many of the problems associated with overt diabetic pregnancies can be seen in infants of gestational diabetic pregnancies, such as macrosomia, neural tube defects, neonatal hypoglycemia, hypocalcemia, hypomagnsemia, hyperbilirubinemia,birth trauma, prematurity syndromes, and subsequent childhood and adolescent obesity.
Prevalence
WEEK 9 + 10 lT for RRB (Renal Reproductive Block)
Submitted by Kuwait-MD on Wed, 03/02/2010 - 6:12pm.
Dear future colleagues,
Hope you are enjoying your mid semester break.
As promised I attach the learning topics (LT) for week 9 and 10, except one LT that I have not circulated as it contributes to week 10 PBL case.
You are not obliged or expected to read the LT during the holiday, but I know some of you have indicated that you might find them useful. You will get all the LT in your study guides once you come back from holiday as usual.
Happy holiday and enjoy yourself,
Regards,
Dr. Ebaa Al-Ozairi
Assistant Professor
Faculty of Medicine, Department of Medicine, Kuwait University
P. O. Box 24923
Safat 13110
Kuwait
Tel: (+965) 24986646
Fax:(+965) 25338907
lung cancer
Submitted by msh fakra esmee on Mon, 25/01/2010 - 11:26am.
Lung cancer refers to a group of neoplastic growths arising from the epithelium of the air passages or lung. Neoplasia is the word given to the process by which tumours form in animals. These neoplastic growths may be described crudely as benign or malignant depending on their likelihood to invade other structures and spread throughout the body. In this dissertation more time will be spent on malignant cancers, as they are both more common in the lungs, and more clinically important.
There are several types of cancers affecting the lungs, they each have different aetiology (though smoking is a recurring factor in most), pathology, characteristic histological features, treatment regimes and prognosis. Understanding the processes by which these cancers develop and cause harm we can work to reduce the incidence of lung cancers and improve the prognosis of sufferers. Here I look at the major cancers, and those with the greatest clinical impact.
Cancers of the lung mainly affect the bronchi and hence bronchial carcinoma is synonymous with carcinoma of the lung, however peripheral adenocarcinomas are increasing in incidence. Cancers of the lung generally share some common characteristics, these are discussed below and any deviations from this will be noted later under each type.
Carcinomas commonly affect the upper lobes more frequently than lower and the right lung more than the left.1 They often present late, when local invasion and metastases are already present, this has encouraged the development of screening programs in an attempt to diagnose at an earlier stage.
There are two ways that cancers can arise in lungs; they can be new, primary tumours arising in the lungs or metastases from distant sites.
SECONDARY TUMOURS
In Vitro Fertilization (IVF)
Submitted by M.R.T. on Mon, 21/12/2009 - 9:07pm.
- 1 comment
- 525 reads
Epicritic and Protopathi
Submitted by M.R.T. on Tue, 10/11/2009 - 4:37pm.
In sensory systems there are two main forms of sensory stimuli that were discussed in the last lecture, epicritic and protopathic. Epicritic relays carry sensation associated with conscious proprioception, vibratory sense and fine touch. Protopathic relays are associated with diffuse touch and temperature stimulation.
Epicritic Relay
The epicritic relay involves fibers with cell bodies in the DRG that enter and ascend ipsilaterally in either the fasciculus cuneatus or gracillius that will synapse in either the nucleus cuneatus or gracillius. The second order neurons cross in the anterior arcuate fibers and ascend in the medial lemniscus to the VPL of the thalamus. The third order neurons then travel in the posterior limb of the internal capsule on their way to areas 3, 1, 2 (the postcentral gyrus).
Protopathic Relay
The protopathic relay involves DRG fibers that enter the dorsal gray and immediately descend a couple of levels in Lissauer’s tract. After their descent they will synapse in the nucleus proprius, cross and ascend in the anteriolateral spinothalamic tract. When they get to the brainstem the tract becomes the spinal lemniscus and it gives off collaterals as it goes up. These collaterals are the fibers of the spinotectal tract that are hidden within the anteriolateral spinothalamic tract. Like the epicritic relay it will synapse in the VPL of the thalamus on it’s way to the postcentral gyrus.
Slow Pain
The regular protopathic relay, as given above, carries fast, diffuse pain. Slow pain is still protopathic but there are five major differences in it’s pathway then in the above mentioned pathway.
1) It synapses in the substancia gelatinosa (substance P is the NT) on it’s way to nucleus proprius.
Delirium & Dementia
Submitted by M.R.T. on Wed, 04/11/2009 - 11:45pm.
www.sergp.org/Presentations/delirium_dementiaAK.ppt
- 2 comments
- 403 reads
Basic Mechanisms Underlying Seizures and Epilepsy[ADVANCED]
Submitted by M.R.T. on Tue, 27/10/2009 - 9:39pm.
Source & Copy rights : By: American Epilepsy Society
http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=epilepsy&part=A1
- 3 comments
- 377 reads
What is a seizure ?
Submitted by rizenhazard on Mon, 26/10/2009 - 2:06am.
- 4 comments
- 345 reads
Increase ICP = papilledema
Submitted by Dr.bisho on Thu, 15/10/2009 - 1:35am.
Papilledema
Fanconi Anemia
Submitted by msh fakra esmee on Thu, 01/10/2009 - 2:36pm.
Fanconi is an inherited anemia. It leads to bone marrow failure, which also makes it what is called an aplastic anemia. (See above) Both parents must carry the gene for Fanconi to be passed on to a child, according to MOD. MOD also says that many Fanconi patients develop myelogenous leukemia. (Read about "Leukemia") Older patients also are at high risk of other cancers such as head and neck, gynecological and gastrointestinal. (Read about "Head and Neck Cancers" "Ovarian Cancer" "Cervical Cancer" "Uterine Cancer" "Stomach Cancer" "Colorectal Cancer")
Iron Deficiency Anemia
Submitted by msh fakra esmee on Thu, 01/10/2009 - 2:33pm.
There used to be a commercial that talked about "iron poor blood." Basically, it was talking about one of the most prevalent forms of anemia, iron deficiency anemia. The body recycles the iron in our bodies and it stores iron in our bone marrow. When a blood cell dies, the iron is reused to make new blood cells. Iron can also be taken from the bone marrow to make new cells. However, we lose iron when we bleed, and if we don't replenish that iron we can have problems. Since the blood needs iron to bind to the oxygen and carry it where it needs to go, not enough iron means not enough oxygen is getting to the cells.
The National Women's Health Information Center (NWHIC) says iron deficiency anemia affects 20 percent of the women of childbearing age in the United States, but only 2 percent of the men. Most women need to ingest more iron than men because of their menstrual periods. They lose a certain amount of blood each and every month. (Read about "Menstrual Disorders") They need to replace that iron. It is recommended that men and postmenopausal women get 10 milligrams of iron a day. Women of childbearing age are supposed to get 15 milligrams and pregnant women 30 milligrams, according to NWHIC, but studies show 90 percent of women do not get enough iron every day.
A number of things can cause iron deficiency anemia according to the American Academy of Family Physicians (AAFP) and NWHIC. They include:
•fad diets that lack needed nutrients
•internal bleeding, usually into the digestive tract, such as an ulcer (Read about "Ulcers" "Gastrointestinal Bleeding")
•poor iron absorption by the body
•not eating enough iron rich foods
Thalassemia / Cooley's Anemia
Submitted by msh fakra esmee on Thu, 01/10/2009 - 2:32pm.
Thalassemia is another of the inherited anemias. The March of Dimes (MOD) says it strikes people from the eastern Mediterranean basin, southern Asians and Africans. (Read about "Minority Health")
There are two main forms of the disease, alpha and beta. Within each form are subcategories. The most severe alpha form can result in fetal or newborn death.
The beta form also has subcategories. According to MOD they are:
•major or Cooley's
•intermedia
•minor also called trait
Transfusions are the main treatment for Thalassemia, according to MOD.
Hemolytic Anemia
Submitted by msh fakra esmee on Thu, 01/10/2009 - 2:31pm.
Hemolytic anemia occurs when the red cells of the blood are destroyed prematurely. The American Academy of Pediatrics says this can result from disturbances on the surface of the red cells or other abnormalities either inside or outside the cells. Certain enzyme deficiencies also make red blood cells more prone to premature destruction
Aplastic Anemia
Submitted by msh fakra esmee on Thu, 01/10/2009 - 2:30pm.
Aplastic anemias, which are rare, occur when the bone marrow is damaged and stops making enough blood cells. The damage can be caused by many things. Some of those causes from the Aplastic Anemia and MDS International Foundation are:
•Genetic: such as Fanconi (See below for more on Fanconi anemia)
•Environmental: such as radiation, chemicals or medications, insecticides and pesticides
•Diseases and conditions: such as viruses, immune diseases and pregnancy (Read about "Microorganisms" "The Immune System" "Healthy Pregnancy")
Severe cases of aplastic anemia are very serious and require immediate treatment. Bone marrow transplants can be necessary. (Read about "Transplants")
Pernicious Anemia
Submitted by msh fakra esmee on Thu, 01/10/2009 - 2:29pm.
Anemia can also stem from low levels of another B vitamin, B-12. (Read about "Vitamins & Minerals") When the body either doesn't get or can't absorb enough of the vitamin B-12, it can cause pernicious anemia. The National Institutes of Health (NIH) say most of the time pernicious anemia is caused by the lack of a substance called intrinsic factor (IF) in your body. IF is normally found in the stomach, and is needed for your body to absorb and use B-12. NIH says that intramuscular injections of B-12 are needed to treat pernicious anemia. This anemia is considered chronic. It should be carefully monitored by a physician and treatment is needed for a lifetime.
Folic Acid Deficiency Anemia
Submitted by msh fakra esmee on Thu, 01/10/2009 - 2:28pm.
A deficiency of the B vitamin folic acid can also lead to anemia. (Read about "Vitamins & Minerals") A lack of folic acid or folate in the diet is considered the main culprit when this occurs. Often alcoholics will develop folic acid related anemia when they get malnourished. (Read about "Alcoholism") Pregnant women also have a need for folic acid. (Read about "Pregnancy and Nutrition") Ensuring an adequate amount of folic acid in the diet is important. The Institute of Medicine says folate can be found in orange juice, leafy green vegetables, beans, peanuts, broccoli, asparagus, peas, lentils and wheat germ. Folic acid is also added to certain grain products, such as breads and cereals. And it is available in vitamin supplements. According to the March of Dimes, the body more easily absorbs folic acid from vitamin supplements and fortified foods. A doctor should be consulted before using supplements
nutritional anemias
Submitted by msh fakra esmee on Wed, 30/09/2009 - 11:55am.
Nutritional anemias are important because they are easily reversed and because their underlying causes, most often unrelated to dietary intake, require individualized assessment. Iron-deficiency anemia (IDA) usually results from iron losses accompanying chronic bleeding, including loss to intestinal parasites, or from gastric disorders or malabsorption in the elderly. Cobalamin-deficiency anemia, the only nutritional anemia with predilection for the elderly, nearly always stems from failure of intrinsic factor (IF)-related absorption. Folate-deficiency anemia, the only nutritional anemia usually caused by poor intake, has nearly disappeared in countries that fortify food with folic acid. Copper-deficiency anemia, which usually results from malabsorptive disorders or from medical or nutritional interventions that provide inadequate copper or excess zinc, is uncommon but increasingly recognized. The prevalences of nutritional anemias, which are not always distinguished from non-anemic deficiency, are uncertain. The mean corpuscular volume (MCV) provides an essential diagnostic tool leading to judicious matching of relevant biochemical changes with relevant anemia. Nutritional anemias usually feature abnormal MCV, whereas the predominant anemias in the aged, especially the anemias of chronic disease/chronic inflammation (ACD/ACI), of renal failure, and of unknown causes, are typically normocytic.
- 2 comments
- 275 reads
The XRAY shows
Submitted by M.R.T. on Fri, 04/09/2009 - 11:02pm.
The XRAY shows which of the following conditions:
constrictive pericarditis
emphysema
bronchial pneumonia
cardiac tamponade
pulmonary edema
Human leukocyte antigen B8 (HLA B8) is associated with
Submitted by Dr.bisho on Thu, 03/09/2009 - 12:57am.
Human leukocyte antigen B8 (HLA B8) is associated with which of the following conditions:
myasthenia gravis
dermatitis herpetiformis
gluten-sensitive enteropathy
chronic active hepatitis
all of the above
acute cellular rejection of solid organ transplants
Submitted by Dr.bisho on Wed, 26/08/2009 - 2:07am.
A 50-year-old man with end stage renal disease from long-standing diabetes mellitus receives a cadaveric renal transplant. A month later, he has increasing malaise. His urine output decreases. Laboratory studies show a rising serum urea nitrogen and creatinine. The allograft is biopsied and seen microscopically to be undergoing destruction by cells which are recognizing graft cells expressing class I HLA antigens. Which of the following cells is most likely to mediate acute cellular rejection of solid organ transplants?
CD4 lymphocytes
NK cells
CD8 lymphocytes
Macrophages
Plasma cells
Which of the following are most numerous cell types in the blood:
Submitted by Dr.bisho on Mon, 24/08/2009 - 4:36pm.
Which of the following are most numerous cell types in the blood:
lymphocytes
neutrophils
monocytes
mast cells
eosinophils
Lymphocytes that do not reach the thymus?
Submitted by Dr.bisho on Sat, 22/08/2009 - 1:26pm.
Lymphocytes that do not reach the thymus become which of the following cell types:
T-cells
B-cells
Plasma cells
Beta cells
N/A
Major source of IL-4, IL-5 and IL-10?
Submitted by Dr.bisho on Tue, 18/08/2009 - 8:52pm.
Which cell is a major source of IL-4, IL-5 and IL-10?
Th1 cells
Th2 cells
cytotoxic T cells
macrophages
N/A
Humoral immunity main cytokines are secreated by humoral immunity main helper/ activator TH2 cells
Role of CD3 component
Submitted by M.R.T. on Mon, 17/08/2009 - 1:37pm.
The role of the CD3 component of the T cell antigen receptor is to:
bind peptide antigen
bind MHC class II
transduce signals
phosphorylate ZAP-70
N/A
Predominant cell types you would expect (2)
Submitted by Dr.bisho on Sun, 16/08/2009 - 7:14pm.
For each of the descriptions of immune and inflammatory reactions, select the predominant cell types you would expect to see from the choices provided below. Infection by an organism that cannot be digested by macrophages and which initiates a cell mediated immune response.
lymphocytes, plasma cells
neutrophils, macrophages and tissue edema
T helper cells, activated macrophages, giant cells
None of the above
All of the above
Predominant tissue response
Submitted by M.R.T. on Sat, 15/08/2009 - 1:10pm.
For scenarios below which is describing immune and inflammatory responses, select the predominant tissue response you would expect to find from the choices listed below. A disease caused by extracellular bacteria that is handled entirely by the innate immune system
acute inflammation
chronic inflammation
granulomatous inflammation
none of the above
All of the above are true
Blood transfusion Reactions
Submitted by M.R.T. on Tue, 11/08/2009 - 11:21pm.
Blood transfusion reactions belong to which type of hypersensitivity reaction:
I
II
III
VI
N/A
In type II hypersensitivity (or cytotoxic hypersensitivity) the antibodies produced by the immune response bind to antigens on the patient's own cell surfaces. The antigens recognized in this way may either be intrinsic ("self" antigen, innately part of the patient's cells) or extrinsic (absorbed onto the cells during exposure to some foreign antigen, possibly as part of infection with a pathogen). These cells are recognized by macrophages or dendritic cells which act as antigen presenting cells, this causes a B cell response where antibodies are produced against the foreign antigen.
An example here is the reaction to penicillin where the drug can bind to red blood cells causing them to be recognised as different, B cell proliferation will take place and antibodies to the drug are produced. IgG and IgM antibodies bind to these antigens to form complexes that activate the classical pathway of complement activation to eliminate cells presenting foreign antigens (which are usually, but not in this case, pathogens). That is, mediators of acute inflammation are generated at the site and membrane attack complexes cause cell lysis and death. The reaction takes hours to a day.
Another form of type II hypersensitivity is called antibody-dependent cell-mediated cytotoxicity (ADCC). Here, cells exhibiting the foreign antigen are tagged with antibodies (IgG or IgM). These tagged cells are then recognised by natural killer (NK) cells and macrophages (recognised via IgG bound (via the Fc region) to the effector cell surface receptor, CD16 (FcγRIII)), which in turn kill these tagged cells.
TH1 dominant auto-immune diseases
Submitted by Dr.bisho on Mon, 10/08/2009 - 3:05pm.
Which of the following diseases is not known to be TH1 dominant?
Rheumatoid arthritis
Crohn’s disease
Systemic lupus erythematosus (SLE)
Type 1 diabetes (DM1)
Multiple sclerosis (MS)
