autoimmune vs H. pylori-induced chronic gastritis (distribution, inflammatory cells, gastrin, sequelae, malignancy, risk factors)・autoimmune
diffuse (body and fundus of stomach , spares antrum)
Lymphocytes, macrophages
↑ gastrin (produced by G cells on the antrum)
Vitamin B12 deficiency/pernicious anemia
★Adenocarcinoma, carcinoid
Other autoimmune diseases
・H. pylori-induced chronic gastritis
affects antrum first and spread to body of stomach (Multifocal; patchy)
Neutrophils, plasma cells, lymphocytes
normal or ↓ gastrin from G cells
Gastric ulcer
Adenocarcinoma, MALT lymphoma
Poverty, living in developing country gastrointestinalUWorldUWorld step2CK HirotoShishido
epidermolysis bullosaEB simplex, is caused by mutations in keratin genes that ☆impair the assembly of keratin into filaments.
It presents in early in life with friction-induced blisters at the ☆palms and soles and other exposed areas.
Lesions typically heal with no residual scarring, although patients may have chronic thickening of the skin of the feet. Infants with EB simplex may develop ☆★oral blisters with bottle-feeding. dermatologyUWorldUWorld step2CK HirotoShishido
methotrexate
mechanism, clinical use, adverse effect, rescueinhibit the production of THF via ↓dihydrofolate reductase
parasomniasREM(beta waves)→ nightmare disorder, REM sleep behavior(patients remember the dream)(more common in adults)
☆↑Ach
NREM(N3, ☆delta waves)→ ☆sleepwalking, ★night terrors(no memory of the dream)(more common in children)
★Reassurance
Administer low-dose benzodiazepine at bedtime if episodes are frequent, persistent & distressing
