Wednesday, May 25, 2011

A little review

I'm copying Caroline. She posted a similar review, and I thought it was fun... so here's hoping that someone, anyone, thinks mine is "fun" too! Haha.

1. You are going to a yoga class with your new friend who you met on the elevator at your apartment complex. Usually you pride yourself in being pretty good at yoga, but you are very humbled when you see this girl's flexibility. She basically has her leg behind her head while doing a back bend. You have never seen anything like it. What is the mechanism of her disease?

2. Your classmate, who has Hashimoto's thyroiditis, notices new bullae on his skin and oral mucosa. He doesn't know what they are from and asks you what you think. You notice that the bullae have a positive Nikolsky's sign, and you suspect a second, potentiallly fatal autoimmune disorder. What is the name for his dermatologic lesion? And what antibody would confirm your diagnosis?

3. You are doing your morning rounds on a patient who has chronic renal failure due to uncontrolled Type II diabetes. You tap on his face and notice a muscle spasm. This positive test tells you what?

4. A Vietnam veteran presents to your office and is positive for HCV, which he acquired from a blood transfusion while fighting in the war. The zone of his liver that will be most affected by his infection contains what important structure(s)?

5. What is the difference between Glanzmann's thrombasthenia and Bernard-Soulier dx?

1. Your new friend has Ehlers- Danlos syndrome, which mechanistically is faulty production of Type III collagen.
2. Your classmate has pemphigus vulgaris and his lesions are termed acantholysis. He will be positive for IgG against desmosomes (anti-epithelial cell antibody).
3. This is a positive Chvostek's sign, due to hypocalcemia. (Remember: renal failure -> no vit. D -> low calcium and phosporus)
4. Zone 1 of liver is most affected by viral hepatitis. It contains branches of the portal vein, branches of the hepatic artery, and the bile ducts.
5. Glansmann's thrombasthenia is a defect in platelet aggregation and Berdnard-Soulier dx is a defect in platelet adhesion.

I know this is not perfect and that I have made mistakes... if you notice them, tell me. Otherwise, I hope this helps you a little! :)

1 comment:

  1. Pemphigus Vulgaris! I just had a qbank question on that. Thanks to you, and a pathoma lecture today (but mostly you) I chose the right answer :) Anti desmosomes, not anti basement mem (Bullous pemphigoid)!!!