relative high lympholyte count in BAL (bronchoalveolar lavage)(normally, 85% alveolar macrophage, 10% lymphocytes, small percentages of neutrophils and eosinophils)
cavitary tuberculosis (TB) vs lung abscessTB→ usually due to reactivated (not primary) mycobacterial infection,
common in the ☆upper portions of the lung,
☆do not have air-fluid levels
types of pneumoniaLobar pneumonia
☆S pneumoniae most frequently, also Legionella, Klebsiella
Intra-alveolar exudate consolidation
(Can involve the entire lobe or the whole lung)
Bronchopneumonia
S pneumoniae, S aureus, H influenzae, Klebsiella
Acute inflammatory infiltrates from bronchioles into adjacent alveoli
(usually the lower lobes or right middle lobe)
histopathology of syphilitic lesionat all stages classlcally demonstrate ☆proliferative endarteritis of small vessels with a surrounding plasma cell rich infiltrate
(eg. aortic aneurysm, condyloma lata)
mechanism of protease for HIV infectionHIV genome contains three major genes
env (gp120 and gp41):
gp120(surface)-attachment to host CD4+ T cell.
gp41(transmembrane)-fusion and entry.
gag (p24 and p17):
capsid and matrix proteins, respectively.
protease cleave gag and pol polyprotein products(gag-pol) into individual HIV ☆enzyme, and structural proteins microbiologyUWorld HirotoShishido
manifestation of vertical transmission of HIV-1Suspect HIV in infants with failure to thrive, diffuse lymphadenopathy, diarrhea, and ☆oral thrush, especially if the mother is a high-risk parent(eg iv drug abuser).
nontuberculous mycobacteriumM avium–intracellulare (causes disseminated, non-TB disease in AIDS; often resistant to multiple drugs). Prophylaxis with azithromycin when ☆CD4+ count < 50 cells/ mm3.
M scrofulaceum (cervical lymphadenitis in children).
papilloma
parvo
pox
polioma
☆adeno→ replicate with DNA dependent DNA polymerase
hepadna
herpes
(transcription of viral DNA into mRNA is facilitated by DNA dependent RNA polymerase)
(retrovirus convert their RNA genome into DNA using RNA dependent DNA polymerase)
(other RNA viruses replicate using RNA dependent RNA polymerase) microbiologyUWorld SIM2 HirotoShishido
HPV carcinogenesisHPV viral protein E6 binds to ☆p53, a tumor suppressor protein that normally inhibits the proliferation of cells with genetic abnormalities. Ubiquitination of the E6-p53 complex induces degradation of p53, leading to unregulated cellular growth.
HPV viral protein E7 binds to retinoblastoma(Rb) protein, which results in the displacement of E2F (a transcription factor that induces cell cycle activation), promoting unregulated DNA replication and cyclin-mediated cell cycling. microbiologypathologyfree120 HirotoShishido
antiretroviral therapy(ART)
the risk of HIV infection occuring in an infant born to HIV positive mother who received no prenatal ART can be as high as 35%
ART reduces the risk of prenatal transmission to 1-2%
Ranke complexThe Ghon complex describes the two initial sites of primary TB infection.
Over time, these sites become ☆calcified and fibrosed and can be visualized on gross pathology and radiographic imaging.(Ranke complex) microbiologyUWorld HirotoShishido
