Common opportunistic causes of diarrhea in HIV patients・cytomegalovirus
☆multiple ulcers and mucosal erosions
giant cells with large ovoid nuclei containing centralized intranuclear basophilic inclusions (owl's eyes appearance)
as with all herpesvirus family, ☆latent infection is established after resolution of the initial infection
what symptoms have higher specificity for Graves disease☆pretibial myxedema, proptosis(Graves orbitopathy)
Graves ophthalmopathy are not mediated by thyroid hormone or adrenergic stimulation and ☆do not respond to beta blockers. However, they are immune mediated, the manifestation usually respond to glucocorticoid therapy.
fibroblasts stimulated by TRAb secrete excess amount of ☆glycosaminoglycans (eg hyaluronic acid) along with adipogenesis, which expand ground substance of retro-orbital tissues
→desiccation(eg a sense of ☆grittiness), tearing endocrinologyUWorldUWorld SIM2 HirotoShishido
cerebral edema
etiology①cytotoxic edema begins hours after the ischemic injury. The ☆failure of ATP-dependent ion pumps leads to the accumulation of intracellular Na+ and water in neural and glial cells despite an intact blood-brain barrier.
②Vasogenic edema follows 24-48 hours later, when the release of inflammatory mediators disrupts the tight junctions of the blood-brain barrier, allowing proteins (eg, albumin) and water to enter the interstitial space.
☆neoplastic lesion can also disrupt
BBB neurologyUWorldUWorld SIM2 HirotoShishido
Southwestern blotidentify and isolate proteins that bind DNA
DNA binding protein→ ☆c-Jun, c-Fos
(proto-oncogenes)
= leucine zipper motif
→☆transcription factor that contains 30 amino acld alpha helical segment that consists of repeated leucine residues at every 7 position geneticsUWorld SIM2UWorld HirotoShishido
mechanism of insulin resistance
effects of insulin on GLUT-4 proteinphosphorylation of ☆serine and threonine residues of insuline receptor leads to insulin resistance
(phosphorylation can be induced by ☆TNF-α, catecholamines, glucocorticoids, and glucagon)
☆increased translocation of the transporters to the cell membrane (this process is activated by PI3K pathway)
→ increase glucose uptake endocrinologyUWorldUWorld SIM2 HirotoShishido
vitamin A functionnormal differntiation of epithelial cells into specialized cells (☆mucus-secreting cells)
(→ ☆normalize follicular keratinization)
pathologic process in liver cirrhosisLiver fibrosis occurs when the sinusoidal ☆stellate cells are activated by cytokines, inflammatory cells, and other stimuli. Persistent activation of stellate cells
→differentiate into a myofibroblast upon injury and plays a large role ln the production of fibrosis in cirrhosis
(nodules of a cirrhotic liver are composed of ☆hepatocytes)
disease caused by missense mutationsickel cell anemia, ☆MCAD deficiency
usual acidic(negatively chrged) glutamic acid residue is replaced by a nonpolar(neutral charge) valine residue, forming HbS
this leads to the formation of a ☆hydrophobic pocket on the beta globin surface that interacts with a complementary nonpolar residue on another hemoglobin molecule→
this causes polymerization of HbS molecules and subsequent erythrocyte sickling
AICM (→☆enlarged cardiac ventricles with mild myocardial hypertrophy and inverstitial fibrosis) is reversible if ethanol intake is stopped prior to the development of fibrosis cardiologyUWorld SIM2UWorld HirotoShishido
