decrease the risk of pneumococcal meningitis☆dexamethasone
dexamethasone prior to the antibiotics has shown to decrease the risk of adverse events(eg seizures, focal neurologic deficits) and death microbiologypharmacologyUWorld HirotoShishido
when do anti-HIV antibodies, HIV p24 antigen, and plasma HIV RNA become positive?RNA→ 2 months after the first infection
p24→ 2 and half months
antibodies→ 3 months microbiologyUWorld HirotoShishido
coxiella burnetiiSpores inhaled as aerosols from ☆cattle/sheep amniotic fluid. Presents with headache, cough, influenza-like symptoms, pneumonia, possibly in combination with ☆hepatitis.
Phospholipase C (degrades cell membranes→ C perfringens too!);
Endotoxin (fever, shock);
Exotoxin A (inactivates EF-2);
☆Pigments: pyoverdine and pyocyanin (blue-green pigment ; also generates reactive oxygen species). microbiologyUWorld HirotoShishido
histopathology of actinomyces(actinomycosis)
Diagnosis is made by identifying the bacteria with unique filamentous, branching patterns and the characteristic sulfur granules, which are formed by calcified mycelial fragments.
Sulfur granules grossly appear yellow; however, hematoxylin and eosin staining gives them an ☆amorphous (rosette -like) basophilic (purple/blue) appearance under light microscopy. microbiologyUWorld HirotoShishido
mecA geneencodes for penicillin binding protein (PBP) 2a
unlike other PBP, PBP 2a has ☆low affinity for beta-lactams and continues to cross link peptidoglycan in the presence of oxacillin, methicillin, ☆cephalosporins, and other beta lactam medications microbiologypharmacologyUWorld HirotoShishido
P aeruginosa (☆cystic fibrosis pneumonia (adult, child→ S aureus), contact lenses)
Nontypeable (unencapsulated) H influenza (most common cause of mucosal infections like ☆otitis media, conjunctivitis, sinusitis) microbiologyUWorld HirotoShishido
inflammatory breast cancerDermal lymphatic space invasion→ breast pain with warm, swollen, erythematous skin around exaggerated hair follicles, ☆peau d’orange.
Poor prognosis (50% survival at 5 years). Often mistaken for mastitis or Paget disease. Usually ☆lacks a palpable mass.
"inflammatory" is a misnomer because the classic skin findings are not due to infection but are instead caused by cancerous cells obstructing lymphatic drainage after spreading to the dermal lymphatic spaces. breast surgeryOBGYUWorld HirotoShishido
invasive lobular (breast) carcinoma↓E-cadherin expression(diffuse gastric cancer)→ orderly row of cells (“single file”) and no duct formation. Often lacks desmoplastic response.
comedocarcinomaSubtype of DCIS(dultal carcinoma in situ). Cells have ☆high-grade nuclei with extensive central necrosis and dystrophic calcification breast surgeryOBGYUWorld HirotoShishido
OCPs/ PCOS to gynecologic malignancyOCPs → ↑cervical cancer, ↑breast cancer ↓ovarian cancer
