Tuesday, 31 December 2013
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
15>
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
PAX (PAIRED BOX) GENES
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.
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 recessive
– adenosine 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.
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