Tuesday, 31 December 2013

WALDEYER RING







WALDEYER RING


-WALDEYER RING


INNER RING.
 = ADENOIDS
 = TUBAL TONSIL
 = LINGUAL TONSILS
 = PALATINE TONSILS

OUTER RING
 = RETROPHARYNGEAL LYMPH NODE
 =JUGULODIGASTRIC NODE
 =SUBMANDIBULAR LN
 = SUBMENTAL LN

IMMUNOSTIMULANTS



Which of the following is/are immunostimulants? (PGI type)

1. Leflunomide
2. Levamisole
3. Lenalidomide
4. Fingolimod
5. Imiquinod

Human Herpesvirus (HHV) classification




Human Herpes virus

Human Herpesvirus (HHV) classification

Type Synonym Subfamily Pathophysiology
 # HHV-1 Herpes simplex virus-1 (HSV-1) α (Alpha) --Oral and/or genital herpes (predominantly orofacial)

#HHV-2 Herpes simplex virus-2 (HSV-2)
 - Oral and/or genital herpes (predominantly genital)

#HHV-3 Varicella zoster virus(VZV)
 - Chickenpox and Shingles

#HHV-4 Ebstein barr virus (EBV), lymphocryptovirus γ (Gamma)
 -Infectious mononucleosis,Burkitt's lymphoma, CNS lymphoma in AIDS patients, post-transplant lymphoproliferative syndrome (PTLD), nasopharyngeal carcinoma.

#HHV-5 cytomegalovirus (CMV) β (Beta) -Infectious mononucleosis-like syndrome, retinitis, etc.

# HHV-6, -7 roseolo virus β Sixth disease- (roseola infantum or exanthem subitum)

#HHV-8

Kaposi's sarcoma-associated herpesvirus (KSHV), a type of
 -Kaposi's sarcoma, primary effusion lymphoma, some types of multicentric Castleman's disease

TODAY’S RANDOM 10 1/1/2014



TODAY’S RANDOM 10 1/1/2014


1. Incudo malleal joint is an examle of?
A saddle joint

2. Stem cell in hair follicles?
Bulge

3. Largest branch of vertebral artery?
Post inf cerebellar

4. Labrynthine artery is a branch of?
anterior inferior cerebellar artery (85%-100% cases) or basilar artery (<15 p="">

5. Damage to nervous tissue is repaired by?
Neuroglia

6. Corpus Striatum consists of?
Caudate nucleus + lenticular nucleus

7. Charcots artery is a branch ?
Middle cerebral artery

8. Tonsils are derived from?
2nd branchial pouch

9. Foramen spinosum transmits?
Middle meningial artery, mandibular nerve

10. Common carotid artery usually bifurcates at?

C4



PRIMARY IMMUNODEFICIENCIES


DISORDERS OF SPECIFIC IMMUNITY
Classification
A. Humoral immunodeficiencies (B cell defects)
1. X – linked agammaglobulinemia
2. Common variable immunodeficiency
3. Hyper IgM syndrome
B. Cellular immunodeficiency
1. Chronic mucocutaneous candidiasis
2. (DiGeorge’s syndrome) Thymic hypoplasia
C. Combined immunodeficiencies (B and T cell defects)--SWAIN
1. Severe combined immunodeficiency
2. Wiskott-Aldrich syndrome
3  Ataxia telangiectasia
4  Immunodeficiency with thymoma.
5. Nezelof syndrome

PAX (PAIRED BOX) GENES

PAX Genes

PAX (PAIRED BOX) GENES


Drugs and Adverse effects

Drugs and Adverse effects

Drugs and Adverse effects

 


PROLAPSE TREATMENT


PROLAPSE TREATMENT













·        

HOW TO CRACK PG ENTANCE EXAMS

Cracking exams

Posted by Dr. Savinay Kapur in his Facebook Wall


Hello folks. When I was preparing for Post Graduate exams, I felt the need for some proper guidance as to how to go about reading, what to read, from where to read and so on and so forth. I would constantly bug my seniors, teachers at my coaching institutes and practically anyone else I could get my hands on for the same! I have repeatedly been asked the same ever since I cleared the November 2012 PG entrances. My personal belief is that everybody reads, but the difference between those who get selected and those who don’t is that the former know what to read and how to read it. So this is my attempt at making things a little simpler for those who are preparing for Post Graduate entrances.

ANATOMICAL REMANTS




Remnants


Review of Repeatedly asked various anatomical remants............

REVIEW OF PRIMARY IMMUNODEFICIENCIES





PRIMARY IMMUNODEFICIENCIES

DISORDERS OF SPECIFIC IMMUNITY
Classification
A. Humoral immunodeficiencies (B cell defects)
1. X – linked agammaglobulinemia
2. Common variable immunodeficiency
3. Hyper IgM syndrome
B. Cellular immunodeficiency
1. Chronic mucocutaneous candidiasis
2. (DiGeorge’s syndrome) Thymic hypoplasia
C. Combined immunodeficiencies (B and T cell defects)--SWAIN
1. Severe combined immunodeficiency
2. Wiskott-Aldrich syndrome
3  Ataxia telangiectasia
4  Immunodeficiency with thymoma.
5. Nezelof syndrome

X-Linked Agammaglobulinemia (Bruton Disease)
1.     Cause: Mutation in tyrosine kinase.
2.     Inheritance: X-linked recessive.
3.     Clinical feature: Recurrent bacterial infection in childhood, chronic giardiasis.
4.     Diagnosis: Absent or decreased B cells, absent plasma cells, decreased Ig in serum.
5.     Treatment: IV gammaglobulin.

Common Variable Immunodeficiency
·        Defective humoral immunity due to lack of differentiation of B cells.
·        Clinical feature: Same as Bruton disease, onset is late, chronic giardiasis.
·        Diagnosis: Normal B cells but absent plasma cells.
·        Others: Increased chance of autoimmune diseases (hemolytic anemia, pernicious anemia) and lymphoid tumors.

Isolated IgA Deficiency
·        Most common of all the primary immunodeficiencies.
·        Clinical feature: Usually asymptomatic, chronic sinopulmonary infection and diarrhea.

Hyper-IgM Syndrome
·        Cause: Mutations in CD40L or CD40, resulting in defective isotype switching.
·        Inheritance: Usually X-linked.
·        Diagnosis: Normal or increased IgM but lack of IgG, IgA or IgE isotypes.

Severe Combined Immunodeficiency
·        Defects in both humoral and cell-mediated immunity.
·        Cause: X-linked – cytokine (IL-7) receptor mutation
·        Autosomal recessiveadenosine deaminase deficiency–the most common enzyme deficiency.
·        Clinical feature: Recurrent infection.
·        Treatment: Bone marrow transplantation.

Wiskott-Aldrich Syndrome
1.     There is loss of cellular as well as humoral immunity.
2.     Clinical feature: Characterized by thrombocytopenia, eczema and recurrent infection.
3.     Inheritance: X-linked.
4.     Diagnosis:
a.     Decreased T cell and defective cellular immunity,
b.     Defective antibody formation to polysaccharide (encapsulated organisms),
c.      Decreased IgM but IgG, IgA are normal or increased,
d.     IgE is also increased,
e.     Decreased ratio of CD4:CD8 cells,
f.       Small platelets in peripheral smear.
5.     Treatment: Bone marrow transplantation.


Thymic Hypoplasia (DiGeorge’s Syndrome)
1.     Cause: Deletion of chromosome 22q11.
2.     Clinical feature: Thymic hypoplasia leads to deficient T cell maturation → increased viral, fungal and protozoal infection.
3.     Parathyroid hypoplasia → hypocalcemic tetany.
4.     It is associated with Fallot’s tetralogy and other congenital anomalies and a characteristic facial appearance.

Nezelof Syndrome
1.     Depressed cell mediated immunity is associated with selectively elevated, decreased or normal levels of immunoglobulin.

Immunodeficiency with Thymoma Spindle cell thymoma
associated with hypogammaglobulinemia, impaired cell mediated immunity and aplastic anemia.



INHERITED DISORDERS OF PHAGOCYTIC FUNCTION

Classification
a. Defective adhesion – leukocyte adhesion deficiency
b. Defective chemotaxis –
1.     Shwachman’s disease,
2.     Lazy leukocyteyndrome,
3.     Job’s syndrome, 
c. Defective microbicidal activity –
1.     Chronic granulomatous disease,
2.     Myeloperoxidase deficiency,
3.     Chediac-Higashi syndrome.

Leukocyte Adhesion Deficiency
Defect:
• Type 1 – defective synthesis of CD18 β-subunit of
leukocyte integrins LFA-1 and Mac-1.
• Type 2 – absence of Sialyl-Lewis X (selectin receptor
on endothelium).
Clinical feature:
• Type 1 – delayed separation of umbilical cord, recurrent
infection.
• Type 2 – severe mental retardation, short stature, Bombay blood group, recurrent infection.

Hyper IgE-recurrent Infection (HIE) or Job’s Syndrome
·        Clinical feature: Eczema, cold abscess, recurrent staphylococcal pneumonia,
·        coarse facies,
·        bony abnormalities,
·        serum IgE > 2000 IU/ml.

Myeloperoxidase Deficiency
Most common neutrophil defect.
• Usually asymptomatic.

Chediac-Higashi Syndrome
1.     Defect: Reduced chemotaxis and phagolysosome fusion.
2.     Clinical feature: Recurrent pyogenic infections specially with Staphylococcus aureus.
3.     Oculocutaneous albinism, nystagmus, peripheral neuropathy, mental retardation.
4.     Diagnosis: Giant primary granules in neutrophils.

Chronic Granulomatous Disease
1.     60 percent X-linked, 40 percent autosomal recessive.
2.     Defect: Lack of one of four NADPH oxidase subunit → absent respiratory burst → decreased production of H 2 O 2 .
3.     Clinical feature: Recurrent infection with catalase positive pyogenic organisms like Staphylococcus aureus.
4.     Lymph node suppuration, granuloma formation which may obstruct GI tract or genitourinary tract.
5.     Diagnosis:
a.     NBT test (screening test)
b.     Absent superoxide and H 2 O 2  production by neutrophils.

Shwachman’s Disease
1.     Decreased neutrophil mobility,
2.     pancreatic malfunction,
3.     bone abnormalities.